Glossary of Slang

“Deputy room
captains” [anuk kang]: detainees with authority over other detainees
of a particular room inside a center, under a “room captain”

“Eat ice cream”
[si karem]: perform oral sex

“Eating betel
nut” [si sla]: punishment of running against a wall until the
detainee’s mouth bleeds

“Eat fully” [si
chh 'eth]: have sex

“Frog leaps”
[lauth kangkep]: punishment of leaping forward from a squatting position
for a certain distance

“Ice” [teuk kak]:
methamphetamine in crystal form

“Leader of a work
group” / “Deputy leader of a work group” [mei krom / anuk
krom]: detainees with authority over a work group (of 10 or so other
detainees) under a “room captain” and “deputy room
captain”

“Ox’s
penis” [k'dor ko]: a police baton

“Room captain”
[mei kang or mei bantup]: detainee with authority over a dormitory inside a
center

“Rolling like a
barrel” [romeal thung sang]:punishment of rolling on the ground
for a certain distance

“Roll like a
monkey” [sva damdoung]: punishment of rolling forward head-over-heels
for a certain distance

“Twisted electrical
wire” [kh'sei oy]:cords of electrical wire twisted together to form a whip

“Welcome” [sva
khoum]: slapping of the face of a new detainee by others in his or her
dormitory

Map of Cambodian
Detention Centers

I. Executive Summary

[A staff member] would use the cable to beat
people... On each whip the person’s skin would come off and stick on the
cable...

—M’noh, age 16, describing whippings he
witnessed in the Social Affairs “Youth Rehabilitation Center” in
Choam Chao[1]

Cambodians who use drugs confound the notion that drug
dependence is a self-inflicted condition that results from a character disorder
or moral failing. When Human Rights Watch talked with these people, they were
invariably softly spoken and polite. They talked openly and honestly about
difficult childhoods (in many cases still underway) living on the streets, or
growing up in refugee camps in Thailand. Often young and poorly educated, they
spoke of using drugs for extended periods of time. Despite many hardships in
their lives, their voices rarely became bitter except when describing their
arrest and detention in government drug detention centers. They did not mince
words when describing these places. One former detainee, Kakada, was
particularly succinct: “I think this is not a rehab center but a
torturing center.”[2]

Kakada’s appraisal was borne out by Human Rights
Watch’s own research. Many detainees are subjected to sadistic violence,
including being shocked with electric batons and whipped with twisted
electrical wire. Arduous physical exercises and labor are the mainstays of
supposed drug “treatment”. Some detainees are forced to donate
their blood. Many suffer symptoms of diseases consistent with nutritional
deficiencies. Those detained in such centers include a large number of children
under 15, as well as people with mental illnesses. People in such centers are
detained in violation of international and Cambodian legal
standards.

In Cambodia, “undesirable” people such as the
homeless, beggars, people who use drugs, street children and sex workers are
often arrested and detained in government centers. This report is an
investigation into the treatment of one such “undesirable”
group—people who use drugs—by law enforcement officials and staff
working at government drug detention centers. While people who use drugs are
also sent to general “catch-all” centers, Human Rights Watch
believes there are currently 11 centers specifically designated for people who
use drugs in Cambodia. The centers are operated by a haphazard collection of
government authorities: the military police, civilian police, the Ministry of
Social Affairs, Veterans and Youth Rehabilitation (Social Affairs) and Phnom
Penh municipal authorities. In 2008, over 2,000 individuals were detained in
such centers throughout the country.

A very small number—perhaps 1 or 2 percent of the
total—enter these centers voluntarily. Roughly half enter drug detention
centers after being arrested by police or unlawfully rounded up by other
authorities for drug use or vagrancy. The other half is arrested at the request
of their parents or relatives. In such cases the families invariably have to
pay for detention despite the fact that Cambodian law requires drug dependency
treatment in government facilities to be free.

The process of arrest and subsequent detention appears to
follow two broad patterns. In some locations (such as Cambodia’s capital
Phnom Penh) poor people who use drugs (as well as other groups of
“undesirables”) are regularly rounded up by police, Social Affairs
staff and others. If they have enough money, or parents or others are willing
to pay, they might bribe their way out of police or Social Affairs detention.
If not, they will be sent to a drug detention center. In other locations in
Cambodia (such as some provincial capitals), poor people who use drugs will be
ignored, or else will be arrested, charged, and sent to prison. In these
locations, drug detention centers primarily or exclusively detain people whose
family is wealthy enough to pay police and/or center staff for arrest and
subsequent detention. Such a distinction is not rigorously observed, as police
still regularly clear the streets of provincial capitals, while people are sent
to centers in Phnom Penh on the request and payment of their parents or
relatives.

Whatever the scenario, Cambodians who use drugs are arrested
and detained illegally. Police rarely tell people the reasons for arrest, or
misrepresent why they are arresting someone. There is no access to legal
counsel in police detention or in subsequent detention in the centers. There is
no judicial authorization of detention, nor any oversight or
review.

Research has shown that drug dependence is not a failure of
will or of strength of character but a chronic, relapsing medical condition
with a physiological and genetic basis that could affect any human being. People
dependent on drugs have the right to access medically appropriate, effective
drug dependence treatment, tailored to their individual needs and the nature of
their dependence. However, the “treatment” and
“rehabilitation” in the centers is ethically
unacceptable, scientifically and medically inappropriate, and of miserable
quality.

Sweating while exercising or laboring appears to be the most
common means to “cure” drug dependence. Center staff often tell
detainees that they must work up a sweat to eliminate drugs from the body. In
some centers, this regime of physical exercise and laboring is augmented by
military drills, group classes on drug issues and supposed vocational
training. In many instances, forced labor and vocational training
activities appear motivated only by benefits to the center staff, as opposed to
the detainees themselves.

If Cambodian authorities think they are reducing drug
dependency through the policy of compulsory detention at these centers, they
are wrong. There is no evidence that forced physical exercises, forced labor
and forced military drills have any therapeutic benefit whatsoever. After a
number of months in the centers, individuals are declared “cured”
because drugs are no longer physically present in the body. One former
detainee, Puth, identified the obvious flaw in the current approach:

I think that success [cessation of drug use] only happens
inside the center but they will use drugs after they are out. The majority [of
detainees] return to drugs... some are sent three times, four times, five times
to the centers.[3]

The existing system of compulsory drug detention centers is
not reducing the number of Cambodians who use drugs. NGO workers and health
professionals in Cambodia criticized the centers as “not working”
and “[merely] being seen to do something.”[4]
Indeed, former detainees said that, rather than “rehabilitate”
them, their detention undermined the skills, resources and human relationships
many had beforehand, and which help integrate people into their community.
According to Chrolong, “After I left [the center] everything had
finished. I lost my job, my girlfriend left me, [and] then I started using
drugs again. I wasn’t using drugs when they arrested me.”[5]

The real motivations for Cambodia’s drug detention
centers appear to be a combination of social control, punishment for the
perceived moral failure of drug use, and profit. Indeed, people who do not meet
the government’s own criteria for drug dependence are often detained. For
example, the National Authority for Combating Drugs [NACD] reports that almost
700 individuals were detained for crystal methamphetamine use in government run
centers in 2008, although 25 percent were “not dependent”
according to the NACD’s own assessment.

Compounding the therapeutic ineffectiveness of detention is
the extreme cruelty experienced at the hands—and boots, truncheons and
electric batons—of center staff. Sadistic violence, experienced
as spontaneous and capricious, is integral to the way in which these centers
operate. Human Rights Watch found the practice of torture and inhuman treatment
to be widely practiced throughout Cambodia’s drug detention centers.

The overwhelming majority of those interviewed for this
report had either experienced the cruel and inhuman treatment described below
or seen it first hand. Former detainees report they were shocked with electric
batons, whipped with twisted electrical wire, beaten, forced to perform painful
physical exercises such as rolling along the ground, and were chained while
standing in the sun. Many of these abuses were for minor infringements of
center rules, although sometimes not even that pretext was necessary. In
addition, Human Rights Watch received reports of detainees being raped by
center staff. Others reported they were coerced into donating their blood to
avoid being beaten or to secure their release from the centers.

Center staff routinely appoint certain detainees to carry out
the majority of the day-to-day control of other detainees and enforce the rules
of the center. Extreme physical cruelty by detainees, sometimes on the direct
orders of staff, is commonplace inside the centers.

Former detainees complained to Human Rights Watch about the
quality and quantity of the food provided to them. They also reported that they
were often hungry. The food provided was often rotten or insect-ridden, and
appears to have been grossly deficient both in nutritional and caloric content.
Detainees reported symptoms of diseases consistent with nutritional
deficiencies.

In 2008 just under one quarter of detainees in government
drug detention centers were aged 18 or below. Contrary to international law, they
are detained alongside adults. Child detainees told us of being beaten, shocked
with electric batons and forced to work. Children also said they were coerced
into donating their blood.

In practice, the government drug detention centers also
function as a convenient means of removing people with apparent mental
illnesses from the general community and public view. Human Rights Watch
interviewed former detainees who reported appalling physical violence against
people with apparent mental illnesses in the centers. There are no services or
resources in the centers for managing mental illnesses.

In
view of the widespread abuses against detainees, the Royal Cambodian Government
should permanently close Cambodia’s drug detention centers. The
Government should commence a prompt, thorough investigation and legal action
(including criminal prosecution) of perpetrators of torture, cruel and inhuman
treatment, arbitrary detention and other human rights abuses, and criminal acts
in Cambodia’s drug detention centers. Human Rights Watch considers that
current detainees are being detained in violation of international and
Cambodian law and should be immediately released. Their continued detention
cannot be justified. At the same time, Human Rights Watch calls on the Royal
Cambodian Government to develop alternative measures of drug dependence
treatment. Without delay, the Government should expand access to voluntary,
community-based drug dependency treatment and ensure that such treatment is medically
appropriate and comports with international standards.

II. Recommendations

To the National Authority for Combating Drugs, the
Ministry of National Defense, the Ministry of Interior, the Ministry of Social
Affairs, Veterans and Youth Rehabilitation, and the Phnom Penh Municipality

Permanently close Cambodia’s drug
detention centers and Social Affairs centers where people have been detained in
violation of international and Cambodian law

Release current detainees in Cambodian drug
detention centers, as their continued detention cannot be justified on legal or
health grounds.

Ensure a prompt, independent, thorough
investigation and legal action (including criminal prosecution) of perpetrators
of torture, cruel, inhuman or degrading treatment or punishment, arbitrary
detention and other human rights abuses and criminal acts in police detention
and in drug detention centers and Social Affairs centers.

Stop the arbitrary arrest of people who use
drugs and other “undesirables” such as homeless people, beggars,
street children, sex workers, and mentally ill people.

Establish an independent body to directly
receive and investigate complaints of torture, cruel, inhuman or degrading
treatment or punishment and other abuses committed by law enforcement officers
and staff at drug detention centers and Social Affairs centers.

To the National
Assembly of Cambodia

Remove the provisions in the current (and
draft) drugs law allowing civil courts to force people into drug dependency
treatment on the request of that person’s spouse, parents, relatives, or
a prosecutor.

Provide that no one can be subject to
detention and compulsory drug treatment except where strictly necessary subject
to the following conditions:

On the basis of two clinical opinions by
qualified healthcare professionals, where a person lacks the capacity to
consent themselves, or is in imminent threat of danger to themselves, due to
drug dependency;

Detention shall be no longer than strictly
clinically necessary to return someone to a state of autonomy in which they can
take decisions regarding their own welfare; In any event any detention shall be
subject to a statutorily defined time limit to review for its continued
necessity;

The person who is detained has the right to
the best available health care: this means treatment on an individually
prescribed plan (reviewed regularly) and the provision of evidence-based
treatment (including, where opioid dependent, opioid substitution treatment);
no one in detention and subject to compulsory treatment may be given experimental
forms of treatment;

The detainee or their legal representative
has a right to challenge the detention decision before an independent body of
addiction experts.

Reform the legal and policy framework for
treatment of drug dependence, including the current Law on Control of Drugs
and the draft drugs law currently under development. The process should include
consultation with and input from human rights experts to advise on human rights
compatible measures and safeguards which should form the basis of such reforms.

Reform the Law
on Control of Drugs so that methadone and buprenorphine are available in
Cambodia for the purpose of providing opioid
substitution treatment for drug dependency.

To the Ministry of Health

Expand access to voluntary, community-based
drug dependency treatment and ensure that such treatment is medically
appropriate and comports with international standards.

Expand access to voluntary, community-based
drug dependency treatment for children, and ensure that such services are age-specific,
medically appropriate and include components of education.

Expand access to voluntary, community-based
drug dependency treatment which addresses the special needs of women and girls
who use drugs.

Ensure that no unlawful payments are
demanded for voluntary, community-based drug treatment services provided by the
government, which under Cambodia’s national law on drugs are provided
free of charge.

To United Nations agencies

Request the permanent closure of Cambodian
drug detention centers and Social Affairs centers where people have been
detained in violation of international and Cambodian law.

Clearly communicate to the Royal Government
of Cambodia that the system of compulsory drug treatment violates international
human rights law and Cambodian law and is not supported by scientific evidence,
nor international standards on what constitutes effective drug dependence
treatment.

Review all funding, programming and
activities directed to assisting Cambodia’s drug detention centers and
Social Affairs centers to ensure no funding is supporting policies or programs
which violate international human rights law, such as the prohibitions on
arbitrary detention, torture and cruel, inhuman or degrading treatment or
punishment.

Actively encourage the Cambodian government
to expand voluntary, community-based drug dependency treatment and ensure that
such treatment is medically appropriate and comports with international
standards.

Develop a WHO, UNODC, UNICEF and OHCHR
position paper establishing principles for the protection and care of people in
drug dependence treatment, including the rejection of treatment systems that,
as a matter of course, forcibly detain and treat people who use drugs.

Support and provide capacity-building
projects for drug dependence treatment to staff of the Ministry of Health and
nongovernmental organizations.

UNICEF should support the expansion of access
to voluntary, community-based drug dependency treatment for children (under the
Ministry of Health and nongovernmental organizations) and ensure that such
services are age-specific, medically appropriate and include components of
education.

To UN human rights bodies

To the UN Special Rapporteur on the Human Rights Situation in Cambodia

Clearly communicate to the Royal Government
of Cambodia that the system of compulsory drug treatment violates international
human rights law and Cambodian law and is not supported by scientific evidence,
nor international standards on what constitutes effective drug dependence treatment.

Recommend the
permanent closure of Cambodian drug detention centers and Social Affairs
centers where people have been detained in violation of international and
Cambodian law.

Work with the Royal Government of Cambodia to establish an
independent body to directly receive and investigate complaints of torture and
other abuses in order to combat impunity.

To the UN Special Rapporteur on Torture and the UN Working Group on
Arbitrary Detention

Raise concerns with the Royal Cambodian
Government regarding the allegations of arbitrary detention, torture, cruel,
inhuman or degrading treatment or punishment, and other abuses committed
against people who use drugs (including children) by law enforcement officers
and staff of drug detention centers in Cambodia.

Request an invitation to visit Cambodia to
investigate allegations of arbitrary detention, torture, cruel, inhuman or degrading
treatment or punishment, and other abuses committed against people who use
drugs, by law enforcement officers and staff of drug detention centers in
Cambodia.

To the UN Committee and Subcommittee against Torture, the UN Committee on
the Rights of the Child, the UN Committee on the Elimination of Discrimination
Against Women

Request further information from the Royal
Government of Cambodia in its periodic reports on the detention and treatment
of those detained in drug detention centers in Cambodia, including women and
children.

Include in Concluding Observations, follow-up
work and/or visits, recommendations on specific measures directed towards ending
abuses against people who use drugs by law enforcement officers and staff at
drug detention centers and Social Affairs centers, and holding perpetrators
accountable.

To bilateral and
multilateral donors and NGOs providing assistance to Cambodia on drugs or
HIV/AIDS issues in Cambodia

Publically call for: i) an end to violations
that occur in Cambodian drug detention centers, ii) an investigation into the
allegations of such violations, and iii) holding to account those responsible
for such violations.

Raise with interlocutors from the Royal
Cambodian Government the allegations of violations, including arbitrary
detention, torture and cruel, inhuman or degrading treatment or punishment, and
the need to investigate them and hold those responsible to account.

Review any funding, programming and
activities which support the operation of Cambodia’s drug detention
centers to ensure that no funding is being used to implement policies or
programs which violate international human rights law, such as the prohibitions
on arbitrary detention, torture and cruel, inhuman or degrading treatment or
punishment.

Support the expansion of voluntary,
community-based drug dependency treatment, including appropriate services for
women and children.

Direct support and capacity-building
projects for drug dependence treatment to staff at the Ministry of Health and
nongovernmental organizations.

III. Methodology

This report is based on information collected during 11
weeks of field research conducted in Cambodia between February and July 2009.
Human Rights Watch interviewed 74 key informants. These key informants included
53 people who currently or formerly used drugs and who had been detained in at
least one drug detention center; seven people who currently or formerly used drugs
but who had not been detained in drug detention centers; and three people who
did not identify themselves as drug users, but who had nevertheless been
detained in centers because they were homeless people, beggars, or street
children.[6] All
former detainees had been detained within three years of the date of their
interview. Thirteen of the key informants were under the age of 18. Human
Rights Watch also interviewed 11 current or former staff members of NGOs and UN
agencies who have knowledge and experience regarding the situation of people
who use drugs in Cambodia.

Human Rights Watch interviewed former detainees from seven
of the 11 current government drug detention centers, including centers run
variously by the Municipality of Phnom Penh, the Ministry of Social Affairs,
Veterans and Youth Rehabilitation (Social Affairs), the military police, and
civilian police. Interviewees include former detainees from six out of the
largest seven centers. Interviews were conducted in the provinces of Banteay
Meanchey, Battambang, Kampong Cham, Siem Reap, and the capital, Phnom Penh.

Included in the key informants were a small number of former
detainees from one Social Affairs center (at Prey Speu near Phnom Penh) not
officially listed as a drug treatment center.[7] It appears
that people who use drugs (as well as others) have been regularly detained
there. Although some people who use drugs reported being detained at a Social
Affairs center at Koh Kor (also known as Koh Romdoul) within the period covered
by this report, their testimony was not included here as that center is
currently inactive. We were unable to identify and meet with former detainees
from certain centers in Banteay Meanchey, Koh Kong, Sihanoukville, or Kandal
provinces.

All interviewees provided oral informed consent to
participate. Interviews were conducted in private and individuals were assured
that they could end the interview at any time or decline to answer any
questions without consequence. Interviews were semi-structured and covered a
number of topics related to illicit drug use, arrest and detention. Where the
interviewees spoke Khmer, interviews were consecutively interpreted between
English and Khmer. The identity of these interviewees has been disguised with
randomly-selected pseudonyms and in some cases certain other identifying
information has been withheld to protect their privacy and safety.

In September 2009, Human Rights Watch wrote to the head of
the National Authority for Combating Drugs to request information on
Cambodia’s drug detention centers and solicit its response to violations
we had documented. This correspondence is attached in Annex 1. As of the
beginning on November 2009, Human Rights Watch had received no response to this
correspondence.

IV. Background

Drug use in Cambodia

While drugs such as heroin and cannabis were widely used in
Cambodia in the 1990’s, the country witnessed a marked increase in
‘ya ma’ (methamphetamine) use in the last decade.
Currently, the main illicit substances used in Cambodia appear to be ‘ya
ma’ and ‘ice’ (methamphetamine in crystal form). People who
inject drugs are most likely to inject heroin. Solvents such as glue are
commonly inhaled, especially by street children. Cannabis and, to a much lesser
extent, ketamine, are also prevalent. The majority of people who use drugs are
between 18 and 25 years old, and few are female. The use of two or more drugs is
very common.[8]

Estimates of the absolute number of people who use drugs in
Cambodia differ widely. The official government figure for 2008 put the number
of people who use drugs at 5,896, a figure very close to the 5,797 for 2007.[9]
However, this number is widely considered an underestimation. A 2007 study
undertaken by the National HIV/AIDS Program (NCHADS) estimates there to be
between 9,100 and 20,100 people who use drugs in Cambodia, of whom
approximately 1,100 to 3,000 are people who inject drugs.[10]
UNODC has been reported as estimating a population prevalence of drug use of
four percent of the entire population, which would signify a figure as high as
500,000 people who use drugs in Cambodia.[11]

Cambodia’s drug
detention centers

In 2008, the National Authority for Combating Drugs [NACD]
reported that there were 2,382 people detained in government drug detention
centers.[12]
This figure is a 40 percent increase from the number of people detained in 2007
(1,719).[13]
According to the NACD’s data, the majority of individuals (1,483 or 62
percent) were aged between 19 and 25 years. Just 15 individuals (or 0.6
percent) were female. The most commonly reported types of drugs used were
methamphetamine (51 percent) and crystal methamphetamine (42 percent).[14]
The NACD also reports that just 1 percent of admissions in 2008 were voluntary,
with 61 percent via the “family” and 38 percent
“judicial”.[15] As discussed
below, the category of “judicial” is a misnomer, given that
detainees are not detained on the basis of a valid court order or with any judicial
oversight. Thus “judicial” means here those who were arrested by
the police without the request and/or payment of parents or relatives.

The government data also reveals that in 2008, 563 detainees
(or 24 percent) were aged 18 or below. 104 detainees (or 4 percent) were
children less than 15 years of age. 116 detainees (or 5 percent) were
classified as “street children”.[16]

Cambodia’s government drug detention centers are
operated by various government entities: the Military Police of the Royal
Cambodian Armed Forces (under the Ministry of National Defense), the
Commissariat-General of the National Police, also known as the civilian or
penal police (under the Ministry of the Interior), the Ministry of Social
Affairs, Veterans and Youth Rehabilitation (also known as Social Affairs) and
the Department of Social Affairs of the Municipality of Phnom Penh.[17]

The NACD‘s “Five year national plan on drug
control” (2005-2010), which includes plans to develop Cambodia’s system of drug treatment and rehabilitation, claims
that human rights principles have been incorporated in Cambodia’s
response to drugs.[18]
However, in another document, the NACD offers the following frank description
of government drug detention centers in Cambodia:

Military-style camps operated by the government are the
primary providers of treatment services for illicit drug users in Cambodia. Most
of the facilities provide limited educational and health services and focus
almost exclusively on exercise and discipline. Most treatment centers are
operated by civilian or military police. A few others are operated by the
Ministry of Social Affairs (MoSAVY) or Provincial administrations.[19]

Although some centers have existed for a number of years,
the regulatory framework for Cambodia’s detention centers was established
in 2006. In October 2006, the Prime Minister issued a Circular on ‘The
implementation of education, treatment and rehabilitation measures for drug
addicts.’ The Circular authorizes provinces and municipalities in
Cambodia, “especially those which have many drug addicts... [to] try to
find one location to organize a drug addict treatment and rehabilitation center
by cooperating with involved ministries and agencies.”[20]
The Circular also calls on the Ministries of Interior, National Defense and
Justice (although not the Ministry of Health) to organize facilities “to
collect drug addicts in order to provide them treatment and education so that
they will become good citizens again in society.”[21]

The government’s own published lists of such centers
are inconsistent.[22] By
cross-checking various lists, and visiting the physical location of a number of
centers, an accurate list of the current government drug detention centers for
drug dependence in Cambodia is reproduced below:

Nº

Name of center

Province

Run by

Capacity

1

Orgkas Khnom [“My Chance”]

Phnom Penh

Phnom Penh municipality

Approx. 200

2

Choam Chao “Youth Rehabilitation Center”

Phnom Penh

Social Affairs

Approx 100

3

Military Police Rehabilitation Center

Battambang

Military Police

Approx 100

4

Borvel Police Rehabilitation Center

Battambang

Civilian Police

Approx 200

5

Chivit Thmey Phnom Bak

Banteay Meanchey

Social Affairs

Approx 120

6

Military Police Rehabilitation Center

Banteay Meanchey

Military Police

Approx 200

7

Police Rehabilitation Center

Siem Reap

Civilian Police

Approx 200

8

Military Police Rehabilitation Center

Koh Kong

Military Police

Approx 30

9

Military Police Rehabilitation Center

Sihanoukville

Military Police

Approx 40

10

Military Police Rehabilitation Center

Kampong Cham

Military Police

Approx 20

11

Chivit Thmey Kampong Kontout “Youth
Rehabilitation Center”

Kandal

Social Affairs

Unknown

The centers on this list are deemed to be for the purposes
of drug treatment and rehabilitation.[23] However,
it would be misleading to consider the list above as exhaustive. Drug use
is a crime punishable by incarceration and (as discussed below) some people who
use drugs are not sent to these centers but instead tried and imprisoned for
the crime of drug use. Further, our research suggests that in addition to the
centers listed, one Social Affairs center (at Prey Speu near Phnom Penh)
regularly detains people who use drugs (as well as other groups of
“undesirables” such as homeless people, beggars, street children, sex
workers, mentally ill people and so on). At the time of this report, the Social
Affairs center at Prey Speu was operational.[24]
Cambodia also has a small number of privately run and NGO run drug treatment
centers.[25]

There are indications that the number of government drug
detention centers in Cambodia will rise in the near future. The 2008 annual report on drug surveillance by the
Secretariat General of the NACD requests that:

Any province or city that has yet to establish centers for
the treatment of drug users should consider establishing a place to keep
[people dependent on drugs] with the aim of enhancing the victims’
well-being and contributing to the maintenance of security, social order and
safety in the provinces and cities.[26]

Indeed, a media report in early 2009 noted that “His Excellency Deputy Prime Minister and Minister of
Interior and [former] Director of National Authority for Combating Drugs Sar
Kheng has advised that any province and city that has more than 50 drug users
should establish drug user detoxification centers...”[27]During a speech
marking the International Day against Drug Abuse and Illicit Trafficking (June
26) in 2009, Prime Minister Hun Sen requested financial contributions to allow
the construction a new drug rehabilitation center in Kampong Speu province.[28]

There are indications that international cooperation may
play a role in the expansion of Cambodia’s drug detention centers. One
likely potential partner is Vietnam. This is despite the fact that Vietnam’s system of compulsory drug treatment has
been criticized for having scant regard for medically appropriate drug
treatment or the human rights principles that should guide drug dependency
treatment.[29]
Independent reviews have found that it is not cost effective and that the rate
of relapse to drug use for former detainees is around 90 percent.[30]

The 2008 annual report on drug issues by the Secretariat
General of the National Authority for Combating Drugs anticipates that the NACD
is “prepared to receive Vietnamese delegates to
Cambodia in order to discuss the feasibility of [Vietnam] giving Cambodia youth
drug detention centers for drug users.”[31] No timeline for this assistance is presented in the
report. However, in June 2009, NACD officials visited Ho Chi Minh City
in Vietnam. According to media reports, the aim of the visit was to discuss how
the two countries could “provide each other with
regular assistance in drug control, drug detox facilities, and rehabilitation,
and in the management of former drug addicts.”[32] When Vietnam’s
Deputy Prime Minister visited Cambodia in September 2009, Cambodian Prime
Minister Hun Sen reportedly requested assistance in building rehabilitation
centers.[33]

Previous reports of abuses in Social Affairs centers

In recent years, there has been considerable criticism of
two particular Social Affairs “rehabilitation” centers. Human
rights organizations documented and reported serious abuses that took place in
the Social Affairs centers at Prey Speu and Koh Kor.[34]
Although not officially listed by the government as drug detention centers,
actual or former drug users interviewed by Human Rights Watch reported being
illegally detained at these centers.

The Cambodian League for the Promotion and Defense of Human
Rights (LICADHO)’s 2009 submission to the UN Human Rights Council's
Universal Periodic Review process provides a succinct overview of the human
rights abuses alleged to have been committed in these two centers and the lack
of serious government investigation into reports of such abuses:

Conditions at both [Prey Speu and Koh Kor] centers were
abysmal – even worse than exist in Cambodian prisons – and included
gross overcrowding and lack of adequate food, clean drinking water and medical
care. In June 2008, LICADHO gained access to the Koh Kor center, despite
efforts to prevent this by staff there, and photographed hungry men, women and
children detained in padlocked rooms. They included a four-year-old boy, a
nine-month pregnant woman, and a comatose elderly woman who subsequently died
inside her locked room.

At Prey Speu center, detainees were routinely
subjected to sadistic violence. Guards raped female prisoners and severely beat
detainees who tried to escape or complained about conditions, according to
former detainees interviewed by LICADHO. At least three detainees, possibly
more, were beaten to death by guards at Prey Speu during 2006-2008, and five others
reportedly committed suicide, according to LICADHO investigations.

LICADHO complaints to the government in mid-2008 led to the
release of detainees at Koh Kor and Prey Speu. However, the Ministry of Social
Affairs has rejected calls to permanently close the centers, and LICADHO fears
that unlawful detentions may resume at either or both of them at any time.
There has been no serious government investigation into abuses at the centers,
and no prosecution of perpetrators. Staff at Prey Speu center who have
allegedly committed rapes and murders - and whom LICADHO has asked the
government to suspend pending a full investigation - continue to work there.[35]
[Citations omitted]

Cambodia’s Drugs Law

Cambodia’s Law on the Control of Drugs, adopted
in 1996 and amended in 2005, provides that consumption of illegal drugs is a
criminal offense punishable by imprisonment from seven days to one month and a
possible fine of between 25,000 to 100,000 riel (approximately US$6-$24).[36]
The same law allows either a Prosecutor or a court “to acquit such
principal of the offense from punishment or to give only a warning to such
person” if the person is not addicted to illegal drugs and the offense
involved “only a very small quantity.”[37]

The drugs law provides that cost of treatment for drug
dependency in a hospital, specialized agency or government clinic “shall
be entirely the burden of the State.”[38]

Methadone and buprenorphine
are both medicines used in opioid
substitution treatment (OST) for people dependent on heroin or other opium
derivatives.[39] The current
drugs law lists both as controlled substances and neither are currently
available in Cambodia (although at the time of writing this report there are
plans to commence a pilot methadone program).[40]

The current drugs law provides that a person can be ordered
into treatment by a wide variety of mechanisms. The prosecutor may issue an
order for a person to attend “any detoxicating establishment” after
having summoned a person to attend court when charged with the offense of
illegal drug consumption. This provision legally requires the issuance of both
an initial summons issued by the court and a treatment order from a prosecutor.
If the person complies with this order the court itself will not punish the
offender.[41]

When someone has been charged with the offense of illegal
drug consumption, a court itself may order the person charged “to
undertake an appropriate treatment measure[s] in accordance with his/her health
condition.” If the person complies with this treatment order, the court
has the authority to issue a warning.[42]
Similarly, following sentencing, a person who has been convicted of illegal
drug consumption may request “medical treatment in accordance with their
respective health conditions” instead of serving a sentence.[43]

A spouse, parents, relatives, or prosecutor may also request
a civil court to order someone into drug dependency treatment. In this case,
the civil court must be convinced that that person is addicted to illegal drugs
and “is known as dangerous for others.”[44]

Even if the law in Cambodia were being used as the basis for
the detention of people who use drugs–which it is not, in the vast
majority of detentions–Human Rights Watch considers that many of these
provisions are overly-broad, with few or no procedural safeguards against abuse
of these mechanisms. These mechanisms may also violate human rights standards,
as they allow a person to be committed to treatment without his or her consent,
disregard whether treatment is in the best interests of the patient, and fail
to limit the period of such treatment, provide oversight, or review the
treatment order. Many people who use drugs may not actually need treatment, as
they are not dependent.

Human Rights Watch is particularly concerned that the
provision allowing a spouse, parent, relatives, or prosecutor to request
detention of a person who is dependent on drugs is open to abuse by family
members or others who are not motivated by the best interests of the drug
dependent person, but rather by embarrassment and/or the desire to have their
family member out of their lives for some time. The provision is also of
concern given that the centers do not provide drug dependence treatment that is
informed by scientific evidence nor comports with international standards.

With UN assistance, Cambodia is
currently finalizing a new Law on Drug Control. Most existing provisions
on measures for treatment are reproduced in a substantially similar form.[45]
For example, article 72(1) on “compulsory treatment” replicates
current article 95 (allowing civil commitment for treatment of people who use
drugs on the request of family members or prosecutor). The draft Law on Drug
Control also contains broad powers for a court to compel a person to accept
drug treatment, similar to those found in the current drugs law.

Human Rights
Watch considers that no one should be subject to detention for compulsory drug
treatment except in strictly circumscribed conditions. Key among these
conditions are that the detention is not simply for anyone dependent on drugs,
but only where qualified healthcare professionals establish that a person lacks
the capacity to consent themselves, or is in imminent threat of danger to
themselves due to drug dependency. The detention itself should be for no longer
than strictly clinically necessary to return the person to a state of autonomy
in which they can take decisions regarding their own welfare. In any event any
detention should be subject to a statutorily defined time limit to review for its
continued necessity. The person subjected to compulsory treatment (or their
legal representative) must have a right to challenge the necessity of detention
before an independent body of addiction experts. Further, the treatment
provided should be a medically appropriate individually prescribed plan,
subject to regular review, that comports with international standards. Under no
circumstances should anyone subject to detention for compulsory treatment be
given experimental forms of treatment.[46]

V. Findings

Human Rights Watch was told of abuses during arrest, such as
physical torture by police to force confessions or reveal information. Human
Rights Watch was also told that police demand money or sex in return for
release from police detention.

Cambodia’s drug detention centers detain people who
use drugs, people with a history of drug use (but not currently using drugs)
and people who have never used drugs. Detention is not for drug
treatment; people who do not meet the NACD’s own criteria for drug dependence
are nevertheless detained in drug detention centers.

In detention, former detainees reported they were shocked
with electric batons, whipped with twisted electrical wire, beaten, forced to
perform painful physical exercises such as rolling along the ground, and were
chained while standing in the sun. Former detainees reported rapes by staff in
the centers. Staff delegate powers to some detainees to enforce
discipline and punish other detainees. As a consequence, extreme physical
cruelty by fellow detainees is commonplace inside the centers. Former detainees
also reported being coerced into donating their blood.

Former detainees complained to Human Rights Watch about the
quality and quantity of the food provided to them. Detainees reported symptoms
of diseases consistent with nutritional deficiencies.

Many abuses—including the administration of electrical
shocks, beatings, and forced labor—were also reported by children.
Children also said they were coerced into donating their blood. Human Rights
Watch also interviewed former detainees who reported appalling physical
violence against people with mental illnesses in the centers.

Abuses during arrest

The military police arrested me... They beat me, hit me,
kicked me while arresting me in a pagoda... After they beat us, they sent us to
a detention center in the military police station.

Reports collected by Human Rights Watch suggest that, from first contact with police to detention in
the police station, severe beatings and other forms of violence are
common. According to former detainees, police use forms of
physical torture, such as the administration of electric shocks or beatings
with gun butts, to force people to confess or reveal information.[48]Police regularly extort money from people
after arrest. People are frequently arrested without a warrant or reasonable
cause, without being informed of the reasons for their arrest, or are lied to
about the reasons for their arrest. They have no access to a lawyer during
their period in police custody or during the subsequent period of detention in
the centers. Police in Cambodia often arrest people who use drugs on the
request of parents or other relatives. No protections ensure that family
members do not act out of embarrassment and/or a desire to have the family
member out of their lives for some time.

Cambodians who use drugs are arrested because of drug use
and vagrancy, but are also frequently arrested in periodic police sweeps of persons
considered “undesirable”. Such round-ups have been occurring
regularly in Phnom Penh for many years, often in advance of important national
holidays or international meetings. The Staff of the Department of Social
Affairs of Phnom Penh, often in cooperation with district and municipal police
and civilian authorities, conduct these raids. According to media reports, the
Deputy Governor of one of Phnom Penh’s districts justified street sweeps
in May 2009 by stating that those picked up by the police “make the city
dirty. We collected them in order to clean the city.”[49]

Treated with contempt, people who use drugs are routinely
denied basic rights when arrested. Teap, who is 14, reported being beaten and
electrocuted in police custody in order to extract a confession.

I was sleeping inside the pagoda compound in the open air...
The police asked me, ‘Did you steal someone’s car mirror?’ I
said, ‘No, I didn’t.’ Then they arrested me and beat me.
Because they beat me I lied and said I stole the mirror. They shocked me with
electrical shocks and beat me with ‘the ox’s penis’ [a police
baton]... It was the police who shocked me: a tall colonel with a walkie talkie.
At first I told him I didn’t know anything and he said ‘This
boy’s so stubborn!’ and grabbed an electric shock baton. Then I
told him I had stolen it: actually I hadn’t stolen it, I was just
scared... They shocked me once. It left a mark on my arm. I lost consciousness
so they poured water on me. I saw him holding a stick with sparkling
electricity. It hurt. My body was shaking when I got the shock.[50]

Kronhong, age 18, described being tortured by military
police, after smoking ‘ya ma’ with a friend, to extract information
about who supplied him with drugs.

They brought us to an interrogation center and started
questioning, like ‘Who are the sellers [drug dealers]?’ It was inside
the military police station. They questioned me for two hours... I did not tell
them who are the buyers then they beat me. They kicked me in the face six times,
also on my spine and my ribs. They kicked me till I fell over then they lifted
me up and smashed me with an AK47 butt.[51]

Duongchem was not told the reason for his arrest and not
provided with access to a lawyer. He describes the beating he received
from police and the subsequent confession he was forced to sign.

The police asked if I stole anything. I said, ‘No,
I’m just a drug user.’ They said ‘You used drugs, where did
you get the money?’... They slapped me with their hands and kicked me in
the stomach and my shin with their boots. My skin was bleeding and the skin was
torn off. They kicked me in the stomach. They beat me to make me confess
that I stole something from the market. Two policemen did this in the police
station, in the interrogation room... I did not confess but the police still
wrote down [a confession]:... At the police station they asked us to put my
thumb print on the report... I just did as I was told to do.[52]

Chrolong reported being arrested without a warrant or
reasonable cause by a security guard near Wat Phnom in Phnom Penh.

I was walking at night and I came out from a dancing club.
I was sitting with my girlfriend... There was no reason given for our arrest. They
said ‘You stroll in the night; strolling at night is not good.’ The
security guard [who arrested me] said this... I never saw a lawyer.[53]

Information from former detainees interviewed by Human
Rights Watch suggests that police often misrepresent the purpose of arrest. For
example, Russey explained he was taken into police custody on a false pretext
and a promise to be released shortly afterwards, although he was subsequently
detained in a drug detention center.

At 11 a.m. they come to arrest me, two military police, one
skinny and one fat. [One military policeman] said ‘Little kid, you
had a fight. Now let me ask you something at my place. Then I’ll let you
go.’ However, when he arrested me he sent me [to the center] without
releasing me and I had my head shaved... I never saw a lawyer.[54]

Former detainees told Human Rights Watch that some police
demand bribes in return for releasing people from police detention. In this
way, some people are able to buy their way out of police custody (and
subsequent detention in a drug detention center). For example, Toh described
how he was released from police custody following his arrest for drug use.

They sent me to the provincial police station. They said we
were using drugs: this was true... They called [our] parents. My mother and my
friend’s mother shared [the amount]: all together it was $200 for five
[people’s release].[55]

Other former detainees told Human Rights Watch how they were
unable to buy their freedom. Putrea said that he was sent to the drug
detention center because he was unable to pay the extortion money to have him
released from police custody. He explained:

[The police] didn’t tell me why I was arrested.
I never saw a lawyer... I was not addicted to drugs. The only difficulty I had
was I had no place to sleep and no food... My boss didn’t
‘guarantee’ me [pay the extortion amount] so they accused me of
stealing.[56]

Tola said that a drug dealer with whom he was arrested was
able to pay for her release, while he was unable to pay the extortion money
(and was subsequently detained at the Orgkas Khnom center).

A woman was released for $50: the police lent her a mobile
phone and she called up a friend... When the person came with the money, the
police let her out. I didn’t get released because I had no money.[57]

Former detainees told Human Rights Watch that arrests of
people who use drugs often follow payment by parents or relatives to the police
to carry out the actual arrest, as well as for the subsequent period of
detention. Sokram, 25, explained that his mother paid military police in
Sisophon to arrest him.

My parents called the police to arrest me. [My parents]
said I am a drug user and I caused trouble to them. The military police
arrested me inside the house while I was sleeping, [at] about 10 p.m. at night.
I learned beforehand that I would be arrested and sent to the military police
center. My mother told me she paid more than US$200 for the arrest. They paid
$50 a month for me to be in the center. I never saw a lawyer. [The police] beat
me when I struggled and refused to go.[58]

Srolao, age 23, explained that the police arrested him
supposedly on suspicion of stealing a motorcycle, but in fact because his
parents paid for his arrest. When he arrived at the center, he was told his
parents paid 1,500 baht (approximately US$45) for the arrest.[59]
Kuhear, 26 years old, reported being arrested by military police when his
mother paid them to do so. The police lied to him about the reasons for
his arrest and only revealed the real reason once he was in police custody in
the drug detention center.

Four military police came to my house. They said they
summoned me [to the military police station] to clarify one question of a
quarrel in a restaurant, a quarrel I had with my friends... They said if I
didn’t agree to follow them, then I would be handcuffed. I just followed
them, it was easier. They intimidated me; they said they would beat me and handcuff
me if I refused to go. They had no arrest warrant. I never saw a lawyer...
They did not tell me anything about drugs at [my] house, only about a dispute.
[Later] in the car, they accused me of using drugs. They said, ‘Did you
use drugs? Tell me the truth or I will beat you.’ I said I used.
Actually, I stopped using drugs three months before I was arrested...[60]

As one NGO staff member with
considerable experience working on drug issues in Cambodia explained to Human
Rights Watch,

Though I fully understand the concerns of family—because
I understand the chaos... drug use ... can [cause] within a family
network—this doesn’t mean a person should be sent to a place [of
detention] by family members without due process. There needs to be a mechanism
that supports family networks that is more in line with the rule of law.[61]

Abuses against women and girls

Currently, there are no detention facilities specifically
for women and girls who use drugs in Cambodia. Cambodian government officials
have told the media that they plan to build facilities specifically for women.[62]
At present, however, women who use drugs are frequently arrested but rarely sent
to drug detention centers. As noted, of the 2382 people admitted to government
run centers in 2008, just 15 individuals (or 0.6 percent) were female.[63]

Although rarely detained in drug detention centers, women
and girls who use drugs are frequently arrested and face detention in centers
(such as Social Affairs centers, but not these exclusively) because they are
homeless, beggars, sex workers or members of other “undesirable”
groups.

Women who use drugs may be forced to secure their release
from police custody following arrest via bribery or in exchange for sex. For
example, Roka described how she was released following her husband’s
bribe of the police.

I went to buy ‘white’ [heroin]. When I bought
it and left the house they arrested me... The police said, ‘If you have
money, I will let you go. If you don’t have money, I will send you to
prison.’ I said, ‘You should talk to my husband at 12
o’clock.’ This happened three days ago. My husband found the
money, $10, to pay the police. At five p.m., my husband came back with $10. At
seven p.m. they set me free.[64]

Minea, a woman in her mid-20’s who uses drugs,
explained how she was raped by two police officers.

[After arrest] the police search my body, they take my
money, they also keep my drugs... They know I never have money, they
don’t even ask me [for a bribe]... They say, ‘If you don’t
have money, why don’t you go for a walk with me? Then I’ll
set you free.’ This happened to me once... They [the police] drove me to
a guest house.... How can you refuse to give him sex? You must do it. There
were two officers, [I had sex with] each one time. After that they let me go
home.[65]

Applicable standards

Arbitrary arrest

Cambodia is a party to the
International Covenant on Civil and Political Rights (ICCPR), which prohibits
arbitrary arrest or detention.[66] The prohibition against arbitrary arrest or detention
means that deprivation of liberty, even if provided for by law, must be
necessary and reasonable, predictable, and proportional to the reasons for
arrest.[67]The ICCPR further provides an enforceable right to
compensation for victims of unlawful arrest or detention.[68]

In order for an arrest to be
reasonable, the evidence at hand would have to satisfy an objective observer
that there are reasonable grounds to believe that the suspect has committed a
crime.[69] The
ICCPR requires an arresting authority to immediately inform detainees of the
reasons for their arrest.[70] The
ICCPR specifies a defendant's right to be informed of charges, to have legal
assistance, and not to incriminate him or herself.[71]

Cambodia’s Criminal Procedure Law provides that a
person may be arrested without a warrant during or immediately after the
commission of a crime.[72] A
person who is remanded in police custody shall be immediately informed of the
reasons for such a decision.[73]
Unfortunately, the law provides that criminal suspects may meet with a lawyer
or another person only after 24 hours have lapsed since arrest–a period
of time when mistreatment, rape and extortion often takes place.[74]

Torture, cruel and inhuman treatment and the use of force by law
enforcement officials

Police inflict serious abuse
on detainees, rising to at least the level of cruel, inhuman, or degrading
treatment or punishment, and often torture.[75]Police
use torture to coerce confessions and testimony from detainees. In evaluating
claims of violations of article 7 of the ICCPR, the Human Rights Committee has
determined that electric shocks amount to torture where the shocks were used to
extract information or confession.[76]Rape in
detention also constitutes torture.[77] All ill
treatment of detainees violates Cambodia’s obligations under the ICCPR
and the Convention against Torture and Other Cruel and Inhuman or Degrading
Treatment or Punishment.[78]

As a party to the UN
Convention on the Elimination of All Forms of Discrimination against Women
(CEDAW), Cambodia has binding legal obligations to protect women and girls from
sexual and other forms of gender-based violence perpetrated by state agents and
private actors alike.[79]

In addition to the binding
provisions of international law above, the UN has developed detailed principles
and rules regarding the use of force by police, to ensure compliance with the
international standards. The UN Code of Conduct for Law Enforcement Officials
expressly limits the use of force by police to situations in which it is
“strictly necessary and to the extent required for the performance of
their duty.”[80] Similarly, the UN’s Basic Principles on the Use
of Force and Firearms by Law Enforcement Officials states that law enforcement
officials, in carrying out their duty, shall, as far as possible, apply nonviolent
means before resorting to the use of force and firearms.[81] The Basic Principles establish that,
“Governments shall ensure that arbitrary or abusive use of force and
firearms by law enforcement officials is punished as a criminal offence under
their law.”[82]

Abuses in detention

Arbitrary detention

I was smoking drugs in a park... and I was arrested.
[The police] sent me to the Social Affairs Department near Wat Moha Montrey. I
spent one day and one night there. They did not tell me anything, they just took
me into custody. I didn’t see a lawyer... [The next day] at 4 pm, they
took me to Orgkas Khnom. They didn’t even ask me my name. I didn’t
dare ask any questions because I was afraid they would beat me.

Cambodia’s drug detention centers often detain people
who do not meet the NACD’s own criteria for drug dependence. In addition
to people who use drugs, the drug detention centers detain a wide variety of
people, such as street children, gamblers, alcoholics and mentally ill people.
While the motivation for detaining these people is to keep the streets clear of
“undesirables”, in other locations in Cambodia (such as provincial
capitals), poorer people who use drugs are more likely to be arrested, charged,
and sent to prison, than detained in drug detention centers. In such places,
centers hold primarily or exclusively those detainees whose parents or family
members buy places in the centers. This is despite the fact that the national
drugs law provides that the state shall bear the costs of drug treatment in
government facilities. The official length of detention varies from center to
center. In practice the length of detention depends on the discretion of center
staff, some of who can be bribed to secure release. In sum, the detention of
people who use drugs in Cambodia can only be characterized as inherently random
and unpredictable.

The manner in which people who use drugs in Cambodia are
detained must also be characterized as illegal. Even the flimsy due process
requirements under the national drugs law to affect the detention of people who
are dependent on drugs are ignored in practice. Whatever the arrangement of
their arrest and subsequent detention, detainees bypass the court system. At no
stage do detainees have access to legal representation. There are no orders
from prosecutors followed by court summons, police charges followed by
court-issued treatment orders, or court hearings. No judicial or other
independent body authorizes the commencement of detention or reviews the necessity
of continuing detention. There is no practical opportunity for detainees to
appeal their detention. In this way, people are detained without any due
process protections.

Following arrest, people are typically held briefly in
police stations, district government offices or the offices of the Provincial
Social Affairs department, before being taken to a drug detention center. Where
the centers are operated by the military police or the civilian police, the
place of subsequent detention may be within the same police compound as the
police office where they are taken upon arrest; they are simply registered and then
detained in another part of the compound. As one NGO staff member with
considerable experience working on drug issues in Cambodia explained:

People can be placed in these centers—they
can’t leave. The time they spend there is completely at the discretion of
the people running the center. Basically, people are detained with no
recourse to the law whatsoever.[84]

Officially, the Social Affairs centers provide
rehabilitation services to people who stay there voluntarily. Indeed, under
Cambodian law, the Social Affairs “Youth Rehabilitation Center” at
Choam Chao is supposed to be an “open” center.[85]
M’noh, age 16, was detained there in 2008. He explained the reality
of this supposedly “open” center:

If anyone tried to escape, he would be punished... Some
people managed to escape, some didn’t. Most who were punished for
escaping would be beaten unconscious. Beatings like this happened every day.[86]

A wide variety of people are detained in the centers. For
example, Kakada, 28 years old, described his fellow detainees at the
“Youth Rehabilitation Center” in Choam Chao:

There are glue sniffers, injecting drug users, gamblers,
people who fight each other and have been arrested, alcoholics, ‘ya
ma’ smokers, very old people and young kids who are beggars along
Monivong [street in Phnom Penh]. Sleeping on the street causes disorder,
that’s why they are arrested.[87]

Pok described his fellow detainees in the police-run center
in Borvel district, Battambang province:

There were two women and the rest were men. [The women] are
karaoke singers but also drug users... There were crazy people who had lost all
memory. There were two of them. There were three or four elderly
people... They said that these adults will stay there for the rest of
their lives. There were also two or three children, about 15 or 16. They were
there because they did not listen to their parents and used ‘ya ma’....
Some [detainees] are ‘ya ma’ smokers, [other detainees are] people
who use domestic violence in families... People who are alcoholics or domestic
violence [perpetrators] get freed one or two months later.[88]

The diverse scope of detainees is not limited to Social
Affairs centers. Makara reported that in the Orgkas Khnom center, the main drug
detention center in Phnom Penh, “There’s also those who are street
kids, injecting drug users, those with mental health problems.”[89]
Momeh, a disabled 15-year-old child living on the street but who had never used
drugs, was detained at the civilian police center in Siem Reap.[90]
Trach, a former detainee of the same center in Siem Reap, explained:

There were ‘ya ma’-, ‘ice’-,
‘k’ [ketamine], glue- [using] people, marijuana people,
methamphetamine users... There are people with mental health problems,
crazy people, recyclers, homeless people, alcoholics who beat their children
when they drink, homeless kids.”[91]

Authorities are aware that actual drug dependence is not a
prerequisite for entry into government drug detention centers. Some centers
force detainees to undergo an assessment of drug use upon admission to the
center; most centers do not. According to a draft report of a joint report of
the centers conducted by WHO and the Cambodian government, assessment tools
such as the “Severity of Dependence Scale” [SDS] and urine testing
“are not used as part of any exclusion criteria.”[92]

It is unlikely that the NACD’s “Severity of
Dependence Scale” [SDS] is reliable even when it is used, given that the
assessment is administered to new arrivals by staff with little or no health
care training, let alone clinical training in drug dependence issues.[93]
Regardless, people who do not meet the NACD’s own criteria for drug
dependence are detained for supposed “treatment” and
“rehabilitation”. The NACD reports that almost 700 individuals were
detained for crystal methamphetamine use in government run centers in 2008,
although 25 percent of these individuals were “not dependent”.[94]

A number of former detainees, including those who frankly
discussed their own drug use, told Human Rights Watch that they were not using
drugs during the stage of life when they were arrested. For example, Svay said
that he was detained at the Orgkas Khnom center for three months despite the
fact that his urine test on admission did not reveal any prior drug use. He
explained: “The doctor of the center told me, ‘You are free from
any drugs... They arrest both users and non-drug users’.” [95]

In some provincial towns in Cambodia, former detainees
believed that whether someone is prosecuted criminally or detained in drug
detention centers depends on family wealth. In these parts of Cambodia, people
whose families cannot buy a spot in drug detention centers are sent to prison,
whereas those with money can bypass prison for drug detention centers. The
centers hold primarily or exclusively those detainees whose parents pay the
centers to detain them. Detention costs between US$50 and $200 per month, an
amount usually paid by family members directly to the center.[96]
This practice is contrary to the Cambodian drugs law, which provides that cost
of treatment for drug dependency “shall be entirely the burden of the
State.”[97]

Toh was imprisoned in 2009 for the crime of illegal drug
use, although he had never been detained in the drug detention center of the
town in eastern Cambodia in which he lives.

There is a rehab center inside the military police station...
I don’t know why they didn’t send me there... They did not tell me
about it. They said ‘You are guilty so you must go to jail.’ The
police did not ask if I wanted to go to the rehab center. No one from [this
poor neighborhood] has been to the military police [rehabilitation] center...
There are a lot of people who use drugs in this community: no-one has ever gone
to the rehab center, just straight into prison. The military police center is
only for the rich families.[98]

Chab, a former drug user from the same community, agreed
with this point: “The practice of law has two ways: the [rich] parents
complain and the kids are sent to the military police while if the police
arrest you [without money], you are sent to jail.”[99]

According to former detainees, authorities running these
centers appear to go to some effort to hide the fact that they only detain
people where there is a financial incentive to do so. Pok is someone who uses
drugs in a provincial town with a drug detention center run by the military
police. He regularly sniffs glue, but “stopped using ‘ya ma’
because it was too expensive.” He was clear about why he is not normally
detained in the center in the town where he lives and why he was recently
detained for a (comparatively) short period:

They arrest only the kids who have parents who can afford
[to pay for detention]. I think they only arrested us [glue sniffers] to
‘fill in’ the population in the center when the high-ranking
officials visit the center. In the center [before we were arrested], there were
‘ya ma’ smokers but no glue sniffers, that’s why they
arrested us... This was for those who come to visit, like [the Prime
Minister’s wife] Bun Rany. She came to visit when I was there...
She gave donations and supported the center so we had enough food to eat. I was
released after 15 days.[100]

The official periods of detention vary from center to
center--in some places it is three months, in others it is six months to a
year. In practice, the actual length of detention is at the discretion of
center staff. Tonloap described how his mother’s payment to the military
police center in Sisophon secured his release after a two-week period of
detention.

[The military police] said ‘...You know, when your
parents come to ‘guarantee’ or ‘sponsor’ you, you will
be released.’ [To] me, this meant paying money. An official said this...
He said this to everybody. I stayed about two weeks. Actually, they should have
released me the same day but my mother did not have the right amount. They
asked for 150,000 riel [approximately US$ 36] but she had 100,000 riel
[approximately US$ 24] .... She paid this to the military policeman who
is a commander...[101]

Ill treatment

They chained [the detainees] at the ankle and attached it
to the flagpole in the sunlight in the middle of the day. I saw it two or three
times... I saw someone chained in their underwear: this is punishment for
running away.

Sadistic violence, experienced as spontaneous and
capricious, is integral to the way in which drug detention centers operate. The
overwhelming majority of those interviewed for this report had either
experienced the cruel and inhuman treatment described below or seen it first
hand. Cruel and inhuman treatment was reported in all centers covered by this
report. Sometimes abuses occurred as apparent punishment for breaking
internal regulations of the centers, such as prohibitions on smoking,
quarrelling with other detainees and escaping. However, cruel and inhuman
treatment is often meted out without explanation or ostensible
justification.

Thouren described being shocked with an electric baton by
staff on a number of occasions, such as when he was caught smoking inside the
Orgkas Khnom center.

On one occasion, I got shocked by a [electric] baton. It
made me faint for a minute. It was the staff [who shocked me]. They said
‘You know you aren’t allowed to smoke.’ It’s like a
burning sensation, real pain, you are shaking. It made me fall down to the
ground.... I’ve been shocked three or four times. You get it for smoking,
arguing, fighting. They have a couple of batons they leave on a wall charging.[103]

Tola described electrical shocks being administered to
punish his fellow detainees in the Orgkas Khnom center after an unsuccessful
escape attempt. After being recaptured,

[The guards] did not shock [the escapees] immediately. The
next morning, they asked ‘Who planned this?’ Then they started to
find out who was the ringleader. When they found two ringleaders they started
to shock them. They brought the ringleaders to the room, questioned them, then
shocked them. I did not see this, but when the men came back to the room I
asked what happened to them. [One man] showed me a big wound on his abdomen.
He said it was from being shocked... He said he fell after he got shocked on
the floor and felt exhausted... The skin looked like it was scalded, it was red
and blistered.[104]

Kronhong related being given an electric shock in the center
run by the civilian police in Siem Reap. He was punished by being electrocuted
for having run away from the center on a previous occasion.

They [re-]arrested me and shocked me... They dare not shock
me here [in town, when I was re-arrested] because they are afraid the tourists
can see... It was a policeman [who shocked me]. He shocked me in front of my
room. First they beat me, then they shocked me and I lost consciousness and
they poured water on me and they pushed me into my room. They punched me on the
head until I had bumps. When they shock [you], you lose energy and you can’t
walk. You feel dizzy and you lose energy. ‘This is because you ran
away,’ the policeman said.[105]

In addition to administering electric shocks, staff also use
whips made out of cords of electrical wire twisted together. Kakada, 28,
tells of being whipped with electrical wire in the Social Affairs “Youth
Rehabilitation Center” in Choam Chao:

The guard beat me with a whip of eight twists of electrical
wire. He asked me to kneel down and cover my genitals.... Then he started to
whip me on my back with twisted electrical wire. It was about my wrist’s
size. He beat me many times, about 10 times. I was in such pain. Sometimes I
cry alone, after the beating, because it was so painful. I did not commit any
mistake: why did they beat me like this? After whipping, they slapped me in the
face. My mouth was bleeding, my back was bleeding...[106]

Another former detainee M’noh, 16 years old, described
witnessing whippings with electrical wire in the Social Affairs center in Choam
Chao:

[The staff member] would use the cable to beat people. He
had three kinds of cable, made from peeling off the plastic from an electrical
wire. One cable was the size of a little finger, one is the size of a thumb and
one is the size of a toe. He would ask which you prefer. On each whip the skin
would come off and stick on the cable.[107]

Staff also beat detainees with other instruments at hand.
Thouren was beaten for smoking a cigarette in the Orgkas Khnom center:

They got the water hose, doubled it in half, and beat me
with it. They do it in the back of the center so no one can see. The only thing
the kids can hear is your yelling. They beat me about 10 times, on my back. It
was like a hose that you water your car with. They made me take my shirt off.
It was the guards who did this: three [were] standing and watching, laughing,
and one... did the beating.[108]

Kuhear described being beaten by a military police trainer
because the staff member was drunk: “He had a stick from a branch of a
tree. He entered the room and beat us. He beat me, he beat us all. I recognized
he was drunk because of his reddened face.”[109]
Vicheaka described a beating he witnessed in the Social Affairs center in Prey
Speu:

I saw the guards beat people up. I saw them beat those who
had been rearrested after they had escaped. The sticks were about as thick as
my arm. I saw them break one man’s leg. I saw the guard lift the
leg up--it was broken.[110]

Detainees are also raped in the centers. One former male
detainee, Kronhong, age 18, reported being forced to perform oral sex on the
commander of the military police center in which he was detained:

Because I was a newcomer I had to do massage for all the
others. The first week I arrived I never got a good sleep because I had to give
massages. Sometimes I had to give massages to the military police and sometimes
the commander... He asked me to press his hands, his feet, to step on him, to
pound him a long time, to pull his hair, until he fell asleep. This
was... the big director [of the center]. After him, I had to do massage
for his subordinates too... You know, the massages were both normal and
sexual... Some massages I had to give were sexual... If I did not
do this, he would beat me. The commander asked me to ‘eat ice
cream’ [perform oral sex]. I refused and he slapped me... Performing oral
sex happened many times... how could I refuse?[111]

The Cambodian human rights organization LICADHO has
documented serious human rights abuses, including gang rapes by staff, which
allegedly took place in the Social Affairs center at Prey Speu.[112]
Former detainees from Prey Speu interviewed by Human Rights Watch corroborated
these reports. Trabek, a drug user who had been detained at Prey Speu, reported
witnessing gang rapes by center staff on numerous occasions:

I saw this with my eyes... They got the girl out from the
room. She was a girl who could not speak... They brought her to the classroom:
no-one sleeps there. They brought the girl [to the room], unlocked the room,
and locked her in. They raped her... I saw three men... it’s very difficult
and shameful to describe. The woman screamed out all the time and there was a
big struggle inside... They are staff working in the center [who raped her]...
‘Normal’ women also got raped. The guards use a pretext to get the
women out of the room, like they made a mistake. Sometimes they raped the same
women five days consecutively because there were no new arrivals. Sometimes
they were sex workers, sometimes not. They raped a mute woman about five or six
times. I saw this with my own eyes. Other times I heard her scream.... I just
heard the way [she] tried to make a sound: the voice was stranger than usual.
The room was just next door. It was always the same three guards [who raped
women], sometimes there were others.[113]

Lolok, a homeless woman who was detained in Prey Speu,
reported:

You know, beautiful women and nice women were taken away to
be raped... After they were taken away, those girls disappeared. They
were about 19, 20 years old. I saw two women taken away from my room... One
guard asked [another guard], ‘Hey, what happened to the beautiful girl
last night? How did you do that?’ [The second guard replied]
‘Before I released her I ate fully [slang for having sex].’[114]

Detainees are also subjected to painful physical
punishments. One common form of physical punishment is the punishment of
“rolling like a barrel”, i.e. making detainees roll on the ground
over a certain distance. The hardness and sharpness of the stones and rocks causes
intense physical pain to the detainees. This suffering is exacerbated by often
having to first remove some items of clothing. Sao demonstrated the punishment
of “rolling like a barrel” to Human Rights Watch by rolling a water
bottle over the interview table, explaining:

After beating, they order those [being] punished to
“roll like a barrel” on the small stones. You have to roll about 50
meters and then back again... It is not smooth ground but bumpy with many
stones. The ground would cause you pain to even walk on it without shoes.
[After this punishment] the body would be cut, grazed. It was the commander and
guards that did this [ordered this].[115]

Atith described being punished by having to “roll like
a barrel” and perform other physical exercises, and then being beaten and
whipped, in the Orgkas Khnom center.

Staff asked me to roll on the ground.... I had to
take off my shirt and trousers and roll on the ground “like an oil
barrel”. I had to roll about 100 meters, then back 100 meters. After rolling
I stood up and fell on my face because of dizziness. My body was a mess because
of the ground. It was very painful.... There were cuts over my body, especially
my forearms because I used them to protect my head. Then they made us do
“frog leaps” for 100 meters [forward] then back 100 meters on the
same road. Then I had to “roll like a monkey”, 100 meters [forward]
then back again. It hurt so much I felt nothing: I just followed their
order[s]. [Then] they hit my buttocks with a wooden pole you use to carry
baskets. They hit twice with full force. You could see a red stripe on me
caused by the stick. Then they used a whip of electrical wire – 3 or
4 wires twisted together. They beat me on the buttocks three times [with the
electrical wire] it was more painful than the stick. I was bleeding... This
happened to me twice: once for quarrelling, once for smoking a cigarette.[116]

Srokaneak described his punishment in the Social Affairs
“Youth Rehabilitation Center” in Choam Chao. After being recaptured
after a failed escape attempt,

They tortured me... the guards gave an order to kneel
down. I had to walk on my knees about 15 meters, 50 times. This was in front of
the center, where we did exercises. It was so painful. When I did not complete
it, I had to do something else. I did only about 20 times. [My knees] were
bleeding and the skin was off the knees. Then I “rolled like a
barrel”: you roll forward on the ground, then back, about 50 or 70
meters. It hurt my back bone and my shoulder bone. Some skin came off and it
cut my skin. I had to do it one time, back and forth. After this they asked me
to clench my jaw and slapped me on the face.[117]

Kronhong describes being punished in Siem Reap’s
civilian police center by being made to stand on one leg in the sun in chains
and then being shackled.

I stood until I fell. It was very hot... I had to stand on
one leg with my arms out: if I drop my foot they beat me. I did not stand all
day, only two hours then I could not endure [more]. Then they beat me. After
standing [like this] I was sick for one week... They chained both of my ankles,
they screwed it tightly. I was nine and a half days in shackles... [My
friend] was shackled about two weeks. When they opened the door we had to walk
in shackles to the dining room. We were also in shackles in the room.[118]

Abuses by detainees

Many abuses that occur in the centers are committed by
detainees against other detainees. However, to characterize these
abuses as spontaneous acts of detainee-on-detainee violence would be profoundly
misleading. Rather, center staff delegate authority to trusted detainees. These
detainees carry out the majority of the day-to-day control of other detainees
and enforce the rules of the center. As Proveuk explained, “I hardly saw
the [actual] guards: the inmates who were there before me were running the
place.”[119] The
authority delegated to these detainees extends to the power to enforce
discipline and punish detainees. Extreme physical cruelty by these detainees,
sometimes on the direct orders of regular staff, is commonplace.

Puth explains that these detainees strictly enforce
the rules of everyday life inside the centers:

You know I was beaten one or two times with a
ruler... It isn’t the manager of the center [who does the beatings]
but the chief of the dormitory is delegated to beat people. If you fall into
the wrong line at meal time or have loud conversations in the room, then
you’ll be beaten.[120]

In Social Affairs centers,
detainees that enforce rules are commonly referred to as “cats” [chhma] who are tasked to watch over “mice” (the
other detainees). As Duongchem, age 20, explained, “We [detainees]
are considered like a mouse and the guards of the room are like a cat. If the
mice run, the cats chase... The “cats” and the staff
are friends.”[121]
“Cats” are tasked with keeping order, for reporting possible escape
attempts and for punishing those who break certain rules. M’noh, 16 years
old, was a “cat” during his most recent period of detention. He
explained his role as a “cat” in the following terms:

I was a ‘cat’. The ‘cats’ are
responsible or in charge of the inmates. I had the right to beat someone who
made a mistake... There were four ‘cats’ including me. I slept
outside, in front of the door. Each of us had one key... We had a separate
[food] ration from the rest of the inmates: we had special rice and sour soup
with oil and the insides of a banana tree... I was responsible for one room, 20
or 21 inmates, to make sure no one went missing. If someone escaped, we shouted
until someone was arrested... I slapped people. For example, if they
didn’t form a line properly, or [were] doing exercise wrong, I would slap
them on the cheek. If it was a little mistake, [they received] two or three
slaps. If it was a serious mistake, it would involve being beaten by [all]
people [in the room] two or three times...[122]

In the other centers (i.e. those run by the Municipality of
Phnom Penh, the military police or the civilian police), the disciplinary
hierarchy is more complex. Each individual dormitory within a center will have
a designated room captain [Mei Kang or Meh Bantup] and one or two
deputy room captains [Anuk Kang]. The detainees may also be divided into
work groups (of 10 or so), with each group having a leader and deputy leader [Mei
Krom and Anuk Krom]. Thouren, a former detainee in his mid
30’s, explained to Human Rights Watch why he was chosen as a room captain
[Mei Kang] and what his position involved:

I was the room captain because of my size, my muscle. I can
intimidate a lot of people. At time to eat, I yell out,
’Attention!’ If you don’t do it, I walk up and slap
you, or take you to the bathroom and punch [you]... I would go into rooms to check
they were clean and neat. I was doing the staff’s jobs... [The staff]
say, ‘Make sure everything is ok, that they do everything
right.’ They tell you to keep order, [that there is] no smoking,
the rooms are kept looking nice, that all the inmates do their work. They say,
‘Keep them in check, give them a beating.’ You can use your hand, a
stick, whatever you want to use, it’s up to you. There are no rules. [As
room captain], you get to eat well, you have people massaging you—if your
body is aching, you call a couple of guys to massage you. You have guys who tie
your mosquito net [in place]... When parents come and bring their children
food, you get half. You are basically the king.[123]

In this way, detainees are used by staff to carry out
physical abuse and other disciplinary measures against other detainees.
Sometimes staff punish detainees themselves and then order supplementary
punishment, perhaps in the form of a serious beating, by other detainees. At
other times, detainees are ordered to carry out all the punishment
themselves.

Human Rights Watch received a number of reports of staff
ordering a large number of detainees to beat a particular detainee, often under
the supervision of detainees. This appears to be common immediately after the
arrival of a new detainee. New detainees are initiated into the disciplinary
regime of the centers by a “welcoming” beating; having all
detainees carry out these beatings serves to legitimate and reinforce the
disciplinary hierarchy in the centers among all detainees. Duongchem’s
testimony is representative of this practice:

[Shortly after arrival] I was knocked out. Other inmates beat
me—I don’t know how many. They just covered me with a blanket and
beat me... They beat me in the face, my chest, my side. I don’t know how
long it lasted, but it was in the room I slept in. The staff had ordered the
inmates to beat me. The staff said ‘The new chicken has arrived,
let’s pluck its feathers and eat it!’ It was a staff person
[who said this]... He walked me to the room [and gave the order]... He locked
the door and the kids started beating me.[124]

Trabek described witnessing one brutal form of punishment
for smoking cigarettes called “eating betel nut”.

In Orgkas Khnom, they make you smoke a cigarette and then
you have to run against the wall until you break your teeth... One man who was
caught smoking had to smoke a cigarette and run against a wall. But he stopped
just before the wall. The room captain said ‘What, you don’t know
how to run against a wall?’ and grabbed his head and smashed it against
the wall until he lost consciousness.[125]

Trabek noted the bitter irony of this punishment, given that
the room captains themselves are those who sell cigarettes to detainees at a
considerable profit.

The closeness of the relationship between the actual staff
and the detainees who enforce rules makes any reporting of abuses by detainees
impossible; they enjoy the same level of impunity as actual staff. Proveuk said
that he was beaten by detainees on arrival. He explained, “If you tell
the guards it will be more difficult for you. You can’t tell the guards
because [if you do], once the door is closed, you are beaten again.”[126]
Thouren, himself a former room captain, explained, “[The other detainees]
could not complain [about detainee-on-detainee abuses]: if they do complain,
they get beaten again. They don’t complain. People know not to
complain.”[127]

There is a striking similarity
between the testimonies of former detainees of drug detention centers and
those, collected by human rights organizations in Cambodia, of former prisoners
incarcerated in the country's prisons. The latter describe a substantially
similar system of control in prisons: certain inmates are given positions of
authority (such as 'chief of cell', 'chief of building' and so on) over fellow
prisoners; violence is meted out, on the instructions of prison guards, to
inmates who allegedly break prison rules or try to escape; and, in some
prisons, new inmates are reportedly “welcomed” by mass beatings by
fellow prisoners. These similarities provide yet more proof that punishment,
rather than treatment and rehabilitation, are central aims of drug detention
centers.[128]

Coerced blood donation

A number of former detainees reported donating blood while
in detention. This practice is shrouded in secrecy, with detainees being
instructed not to talk about blood donations to other detainees. According to
Sarika, age 15:

I used to see the staff selecting the fat and healthy kids
[to go] outside the center, about 10 of them, but I don’t know why. If we
asked they would beat us, saying ‘Why do you want to know?’ They
took them outside the center for half a day. I never asked where they went.
They said that this is a secret, both the staff and those kids said this... The
staff came and pointed their finger at these people [to summon them], because
they can do anything in that place... [The other detainees] never told me
what happened. They were told by others not to tell other inmates when they got
back... When they came back they had bandages on the crook of their arm. They
walked with their arm held like this [with one forearm folded up close to the
chest]. They looked very pale.[129]

Coerced blood donation was reported by former detainees of
the Social Affairs “Youth Rehabilitation Centre” in Choam Chao as
well as the military police center in Banteay Meanchey. Based on interviews
with former detainees, it appears that the practice of blood donation in the
centers involves either a van with medical staff coming to the center from
nearby hospitals or clinics, or staff from the center taking detainees to the
hospitals. A number of detainees reported that this was a voluntary practice
and that they were able to say no to the requests for donations. Some former
detainees report they were remunerated for their blood donation. However, some
former detainees reported to Human Rights Watch that they were coerced into
donating. Coercion takes the form of being intimidated into donating blood
because of fear of reprisals by staff, as well as donating in order to secure
release from a center.

Malis, 16 years old, reported he was forced to donate his
blood:

The [staff] said ‘Please help the people who have
accidents.’ The [staff] walked me to where I got my blood pumped.
They said ‘Now, little kid, I want to tell you that a hospital needs our
rehab center to donate blood because the hospital needs type A and B. Your
blood is similar and they lack that type of blood.’ I said ‘I
can’t! Pumping blood is scary!’ He said, ‘[It’s]
no problem,’ and walked me to the pumping van. I felt very scared. They
forced me.

He explains:

Three of us had our blood pumped. It was in the van: it was
big and equipped with machines. They make you lie down then you stretch out
your hand and they use a kind of bandage to tie your arm and they start
pumping.[130]

Duongchem explains that he donated blood because he
felt threatened by a staff member:

[The staff member] talked to me a few days before [doctors
came to the center]... He said, ‘If you donate blood and don’t want
to get hurt by the inmates, I can help you.’ There was a meaning [to his
sentence]. I thought to myself that this was his threat. I was afraid of being
beaten and also afraid of [a different staff member]. He said, ‘Hey,
little brother, if you don’t want to get beaten and bullied you should
donate the blood and I will tell them not to bully you.’

When doctors came to the center to take blood donations a
few days later, Duongchem describes the presence of these staff pressuring
detainees into donating their blood:

Those kids [who donated their blood] were afraid of [the
staff member] who was there: before, he beat people with electrical wire,
cruelly. He did not call [people to donate], but he stood behind the kids. The
kids were so nervous. There were only two staff [present]... When kids see
[those staff members] arrive it’s like seeing a tiger. They were
trembling. I was the only one who volunteered. The rest were scared and this is
why they donated blood.[131]

Teap, 14 years old, explains that he donated blood in order
to receive money and to secure his release from a center. A van came to
the center to collect blood from the detainees.

There were five people who donated. Me, I was the youngest,
the rest were adults. I was 13... They said it was not forced, but voluntary.
They said each would get $20 and get free. Because I wanted to leave the
center, I donated my blood. They said if you donated your blood, you can get
money and walk away. I got money: I got $20. I took a motorcycle taxi to [a
nearby city].[132]

Beng also reported that he donated blood at two different
hospitals in order to receive money and in order to be released from a center.
In total, he reported donating blood about ten times and released from the
center three times.

[The boss of the center] said ‘Pump the blood and
I’ll give you money.’ I got $10- from [the first hospital] doctor...
The boss of the center] said ‘I’ll give you money and I’ll
let you go.’ ... [In the second hospital] I got money: the same
amount... [While] I got $10, [the boss of the center] got $50. I stood outside
and I saw the medic pass the money to him. It was a woman medic. It was $50, I
saw this... In [the first hospital]: I stood behind [the boss of the center]
and saw him. The doctor gave money to [the boss of the center], $50.[133]

Applicable standards

Arbitrary detention

Human Rights Watch considers that Cambodia’s drug
detention centers routinely hold people in violation of international and
Cambodian law. Article 9(1) of the ICCPR declares that “No one shall be
subjected to arbitrary arrest or detention [or] be deprived of his liberty
except on such grounds and in accordance with such procedures as are
established by law.”[134]
Detention is considered “arbitrary” if it is not in accordance with
law. It is also arbitrary when it is random, capricious, or not accompanied by
fair procedures for legal review.[135] International
law grants a detainee the right to challenge the lawfulness of his or her
detention by petitioning an appropriate judicial authority to review whether
the grounds for detention are lawful, reasonable and necessary.[136]

Article 14 of the ICCPR provides basic fair trial rights,
including the presumption of innocence, the right to a public hearing and to
review in case of criminal conviction “by a higher tribunal according to
law.”[138] The UN
Working Group on Arbitrary Detention has previously noted that it has been

informed by several sources that, in some countries, the
disabled, drug addicts and people suffering from AIDS are detained in places
that are incompatible with their state of health, sometimes without treatment
and without it having been established that their detention is justified on
medical or public health grounds. The Group is concerned because it is
vulnerable persons that are involved, people who are often stigmatized by
social stereotypes; but it is concerned above all because often such
administrative detention is not subject to judicial supervision... With regard
to persons deprived of their liberty on health grounds, the Working Group
considers that in any event all persons affected by such measures must have
judicial means of challenging their detention.[139]

International human rights
law obliges the state to provide an enforceable right to compensation for
violations of the right to liberty of the person and to security of the person.[140]

The Constitution of Cambodia
provides that “[t]he prosecution, arrest, or detention of any
person shall not be done except in accordance with the law.”[141]
Illegal arrest or detention is punishable by imprisonment of up to 10 years if
the detention last for longer than one month.[142]
The Minister of Social Affairs, Veterans and Youth Rehabilitation issued an
Instruction in August 2008, prohibiting the forced “collection or
management of vagabonds” in Social Affairs centers. The same Minister
issued an instruction in August 2006, establishing that the Social Affairs
center in Choam Chao is “an open center”, meaning that people
should not be detained there against their will.[143]

Human Rights Watch considers that the provisions in the national
drugs law are overly broad and open to abuse.[144]
Under the Law on the Control of Drugs a person can be ordered into
treatment through a wide variety of mechanisms. However these mechanisms
require:

a treatment order from the prosecutor (following the
issuance of a court summons);[145]

a criminal court treatment order (before trial, once
someone is charged or in place of a sentence, once convicted);[146]
or

a civil court order (on the petition of a spouse, parents,
relatives, or prosecutor if convicted once the court is satisfied that
that person is addicted to illegal drugs and “is known as dangerous
for others.”)[147]

As noted in the discussion of Cambodia’s drug law, these
minimal requirements are insufficient to protect the human rights of people who
use drugs in Cambodia. However, in reality, even these steps are not complied
with. There is no judicial authorization of detention, nor any oversight of
detention or opportunity for review.

Torture and cruel and inhuman treatment

According to the ICCPR,
“all persons deprived of their liberty shall be treated with humanity and
with respect for the inherent dignity of the human person”[148] and “[n]o one shall be subjected to torture or
to cruel, inhuman or degrading treatment or punishment.”[149] The Convention against Torture, to which
Cambodia became a party in October 1992, contains a similar absolute
prohibition on the use of torture. The UN’s Standard Minimum Rules for
the Treatment of Prisoners states that “[c]orporal punishment ... and all
cruel, inhuman or degrading punishments shall be completely prohibited as
punishments for disciplinary offences.”[150] WHO and UNODC note that “[i]nhumane and
degrading practices and punishment should never be part of treatment of drug
dependence.”[151]The Constitution of Cambodia states that
“[c]oercion, physical ill-treatment or any other mistreatment that
imposes additional punishment on a detainee or prisoner shall be prohibited.
Persons who commit, participate or conspire in such acts shall be punished
according to the law.”[152] For
its part, the criminal law provides that “[n]o detainee shall be
subjected to cruel, inhuman or degrading treatment or punishment, nor be beaten
or tortured.”[153]

All of the forms of ill treatment described in this report
are strictly prohibited under international law. For example, the painful
physical exercises or being shackled and made to stand in the sun violates the
prohibition on torture, and cruel and inhuman treatment or punishment. Some of
the ill-treatment unquestionably constitutes torture. For example, the
administration of electric shocks and beatings (including whippings and blows
with a rifle butt or bludgeons) have been considered a form of torture by the
Special Rapporteur on Torture.[154]

A number of instances of
sexual abuse of detainees by staff documented in this report involve staff
members who use force, the threat of force, or other means of coercion to
compel a detainee to engage in sexual activities. Rape has been authoritatively
defined as “a physical invasion of a sexual nature, committed on a person
under circumstances which are coercive.”[155] Rape and other forms of sexual assault in detention
are torture.[156]

Cambodia has a clear legal
obligation to investigate credible allegations of torture and cruel and
inhuman treatment or punishment. The Convention
against Torture obliges states to investigate wherever there are reasonable
grounds to believe an act of ill-treatment has been committed, even where a
victim does not initiate the complaint.[157]

Abuses by detainees

In defining torture and cruel, inhuman or degrading
treatment or punishment, the Convention against Torture includes not only acts
committed by
public officials, but also acts committed with their “acquiescence”.[158]

The UN Minimum Standard Rules for the Treatment of Prisoners
provides “[n]o prisoner shall be employed, in the service of the
institution, in any disciplinary capacity.”[159]
The Minimum Standard Rules are explicitly incorporated into Cambodia’s
criminal code.[160]

Coerced blood donation

Because of the invasive nature of coerced blood donation,
this practice violates an individual’s right to bodily integrity.[161]
Remuneration for blood donation is also against Cambodian law.[162]

WHO recommends that blood donation should be voluntary and
non-remunerated. According to WHO:

The global burden of disease due to unsafe blood
transfusion can be eliminated or substantially reduced through an integrated
strategy for blood safety which includes... [c]ollection of blood only from
voluntary non-remunerated blood donors from low-risk populations...[163]

Taking blood from populations at high-risk of HIV infection,
such as people who use drugs, endangers the safety of Cambodia’s blood
transfusion system. According to data from November 2008, 3 percent of donated
blood units were not screened for HIV “in a quality assured manner.”[164]
In 2006, a UNAIDS-sponsored report recognized:

The majority of [blood] donations are from replacement
donors and the system continues to be infiltrated by paid donors. The
government has limited budget for ensuring blood safety, which remains a
critical issue. Coverage of blood screening is variable and there are no set
standards or procedures for ensuring quality.[165]

Drug treatment and living conditions

Denial of drug dependence treatment

They made me exercise... I was vomiting. I felt they just
exploited me. I just wanted to get out [of Choam Chao.]... If I was tired
and could not do exercise then the room captain would come and beat me.

In terms of
the ethical standards applicable to treatment, WHO and UNODC advise that drug
dependence should be considered as any other health-care condition.[167] Some of the key principles
associated with positive treatment outcomes include:

Drug dependence is a
chronic and relapsing disease;

No single treatment is
appropriate for everyone;

An individual’s
treatment and services plan must be assessed continually and modified as
necessary to ensure that it meets his or her changing needs;

Medications are an
important element of treatment for many patients, especially when combined
with counseling and other behavioral therapies;

Detoxification is only the
first stage of addiction treatment and by itself does little to change
long-term drug abuse; and

Treatment must attend to
multiple needs of the patient (often including mental health issues).[168]

As WHO and UNODC note, “neither detention nor forced
labor have been recognized by science as treatment for drug use
disorders.”[169]The human rights principles
applicable to effective drug dependence treatment are discussed in greater detail
below.

Human Rights Watch found that the mainstays of treatment in
Cambodia’s drug detention centers were forced physical exercise and
labor. Those in charge of the centers were determined to make the detainees
sweat with the stated aim of removing drugs from the body. Indeed, sweating
while exercising or laboring appears to be the main means for treating drug
dependence in the centers. In some centers, this regime of physical exercise is
augmented by military drills, group classes on drug issues and supposed
vocational training. As with all activities in the centers, participation
is frequently enforced by physical brutality on the part of center staff or
detainees.

Most of the facilities provide limited educational and
health services and focus almost exclusively on exercise and discipline. ... In
most cases no assessment of participants’ physical or mental health is
undertaken on admission to the center. None of the centers provide formalized
medical detoxification services, and no medication is used to stabilize
residents in acute distress (from withdrawals). The focus of the facilities is
on rehabilitation of illicit drug users. Drug dependence rehabilitation
generally involves activities such as exercise, vocational training such as
haircutting and farming, counselling on morals/religion, and group counselling
sessions.[170]

Experts dispute that the policy of
compulsory detention at these centers is working. A Cambodian health professional gave his personal assessment of
Cambodia’s system of compulsory drug treatment:

My personal opinion is that it
doesn’t work. When they are released without a good package of
treatment- including counselling, psychological support, options for them when
they are released for shelter- then they’ll go back to addiction. There
are no social services to help them find a way to stay off drugs... [Those in
charge of the centers] don’t think of this stuff... They see
[treatment] as three months [detention], the drug is out of the body, so they
are “cured”. But it’s not working: [former detainees]
relapse! They just get rid of these people, they say ‘there’s
no more drug users in Phnom Penh’ [and that] ‘there are no more
people on the street’. But it’s not working.[171]

As one NGO staff member with considerable experience working
on drug issues in Cambodia explained,

The measure of [drug dependence treatment in Cambodia] is
whether... someone’s body contains no drugs when they step out the gate
[of a center]. There is no follow up, there are no alternative lifestyle
strategies... and there is no cooperation with agencies or organizations that
might be able to provide such alternative strategies. This means that
many former drug using people have no choice but to return to the places
containing the associative factors of their previous drug use.[172]

Forced physical exercise

Across the centers covered in
this report, former detainees reported having to perform rigorous physical
exercises on a regular basis. Often these sessions begin early in the
morning--at 6 or 7 o’clock--and might be followed by an equally grueling
session in the afternoon. Exercises might involve running, calisthenics and
training exercises such as push-ups. The declared goal of such exercises is to
make detainees “sweat out” the drugs from their bodies in order to “cure”
them of their addiction. The director of the military police center in Sisophon
explained the approach in an article in a Cambodian newspaper: “Here we train them the same as military police, make
them fit, make them sweat out the badness.”[173]

According to Russey, 17 years old and a former detainee of
the military police center in Battambang:

[Daily exercises included] abdominals, push-ups, hand and
feet movements, [a movement called] ‘crow jumping’. It was
for our health: to be wise and strong. ‘When you exercise you sweat, and
when you sweat the drug substance will be removed’– the commander
of the military police said this, before the exercise started. After this
speech, we started exercise.[174]

M’noh, age 16, explained the exercises in the Social
Affairs “Youth Rehabilitation Center” in Choam Chao:

There were 12 kinds of exercises, including ‘push
ups’. [In a session] we had to do 50-100 ‘push ups’. If you
dared to rest on the ground, you had to do an additional 20. If you
couldn’t do this you were beaten. We also had to cross our legs, do arm
exercises, sit-ups, raising your hand and touching the ground, stand on one
foot with two hands straight in front... [The exercises] would last for 1 hour
once a day, sometimes less. It was 5 days a week. They said it was detoxifying
to the addictive substances. The big boss [of the center] said... ‘Doing
exercise will make you sweat and the addictive substances will come out through
the sweat.’[175]

Former detainees report the exercises were extremely
grueling. According to Kuhear, “I felt miserable [when exercising]. I
never had such training before.”[176]
Despite the physical demands of these exercises, former detainees report being
beaten if they were unable to complete them or made a slight mistake in
performing them. According to Veary, “I was beaten when I did something
wrong like [a mistake] in doing the exercises or falling in line... Sometimes
they used the slat from the bed or a branch from a tree.”[177]

Forced labor

People in the centers pass much of their time clearing
grass, growing vegetables, or tending to animals in the center. The
consequences of not performing such labor are serious. This is particularly the
case for detainees who report being sick inside the center. Mesa, 24 years old,
described being shocked with an electric baton by a staff member of the Orgkas
Khnom center to force him to work when he was sick:

One day I was under the blanket with a fever and a headache
and my body was weak. I was shivering on the floor... The group chief came in
by the order of the room captain to get me out, twice. I told the group chief I
could not. Then [a staff member], the military trainer, said, ‘Let me see
the sick man!’ He came in with an electric baton and shocked me. [178]

People who are dependent on drugs will experience withdrawal
symptoms after they stop taking drugs, such as abdominal cramps, nausea,
vomiting, bone and muscle pain, insomnia, and anxiety.[179]
Staff also force detainees to work when their sickness is related to withdrawal
from drugs. Indeed, laboring in the field is claimed as therapeutic: as with
the physical exercise, staff explain that sweat will remove the illegal drugs
from their bodies. As Kumpheak explained:

[After I entered the Orgkas Khnom center] I felt sick for
about two weeks but they allowed me to rest for only three days. I asked
permission to stay [resting] longer, but they did not allow [this]. One of the
staff in the center said ‘If you do not work and sweat, the drug
substance will remain a long time. Laboring is to sweat away the drugs
and you will recover.’... I believed that if I labored harder the
drug would go away through the sweat. It was difficult to work but I kept at
it. I felt exhausted while I was working. My joints were painful. I felt tired
and dizzy, I was vomiting. I had to hoe the ground and dig the pond to make a
fish pond. We [also] planted vegetables.[180]

Puth describes his process of forced labor during withdrawal
from drugs in the Orgkas Khnom center:

I had diarrhea, stomach pains. The next morning [after
entering the Orgkas Khnom center] I could not get up. Then they told me to go
and hoe the ground to sweat the drugs away. The guards asked the leader of the
dormitory to order me to hoe the ground as an ‘antidote’ to the
drug. I told them that I could not do it. They asked me to go and see the
doctor in the center to get some medicine... The doctor said the medicine was
for diarrhea and stomach pains... [The doctor gave me] four or five tablets,
but it didn’t help. I was so exhausted. Then the dormitory leader beat me
up with a ruler... I told him that I needed rest, but he said I was pretending.
He said ‘You still can walk...’[181]

According to Thouren, who was also detained at the Orgkas
Khnom center, “[w]hen you are drug sick [withdrawing from drugs], you
feel like you are going to die. But when you have to work on top of it,
it’s like torture.”[182]

In addition to forced labor inside the center, Human Rights
Watch received reports of work gangs of detainees that labor outside some
centers. These labor schemes appear small in scale and differ from center to
center. Labor in work gangs might involve cleaning streets and public parks. In a speech in May 2009, the Prime Minister
called on the NACD to set up more drug detention centers, adding “you must mobilize [people dependent on drugs]
to help support the society in order to repay their indecent deeds... they have
to clean the public spaces, roads, gardens, maintain roads, sewage system and
[undertake] canal renovation.”[183]

At other times, work gangs might perform construction work,
sometimes on a building owned by center staff or private individuals. While
some detainees were paid small amounts of money for their construction labor,
others were paid nothing. Detainee accounts received by Human Rights Watch
indicate that such construction work was motivated by benefits to center staff,
as opposed to the detainees themselves.

Sokram describes the intermittent construction work he
carried out while detained at the military police center in Banteay Meanchey:

We did work: broke stones, carried soil, did
masonry... It was only sometimes [we did this labor], when they needed
manpower. For example, someone needs some construction work done, it is
required [of us to work] two weeks or a month... I was never paid, nor the
others.[184]

Duongchem reported working in construction on apparently
private projects around the center where he was detained. He also reported
being beaten in order to make him work.[185]
Veary, 23 years old and a former detainee of the Social Affairs run center in
Choam Chao, described helping construct a building nearby the center owned by
staff:

There was construction work, to build a house for the staff
[member]. Each time they brought two or three people [from the center] to work.
It was right in front of the center. We were porters, we carried cement bags.
After work, we came back [to the center]. I just carried cement. We worked
until the house was completed. I worked every day for three months. We worked
from 7 a.m. until lunchtime, had lunch break from 11-1, then started at 1 until
5:30 p.m. It was only for 2 or 4 people [who worked on this building]. [A staff
member] gave us 1,000 to 2,000 riel [approximately US$ o.25-0.50] a day.[186]

In addition to forced labor, “vocational
training” activities take place inside some centers. For example,
these might involve learning haircutting, motorcycle repairs or carpentry. Some
centers also have English or Khmer language classes. However, in the case study
below, one detainee related his vocational training experience in carpentry.
Like the forced construction labor (above), the vocational training in this
case exploits the detainees’ labor for the benefit of center staff.

“Made by the
victims”: A case study of “vocational training”

Vicheaka,
a former detainee of the Orgkas Khnom center, explained his carpentry work:

I did
carpentry and made [wooden] chairs... We [also] improvised rubbish bins and
flower containers from abandoned tires... I have seen them outside [the
center]: a lot of people buy them. They also buy chairs... One chair is
[worth] about $15—the parents buy them. Some [parents] buy chairs and
donate them back to the center... so we inscribe their name on the chair. The
teacher kept the money... Some people come to the center to order chairs:
some parents order 5 chairs, others order 10 chairs, then take them home.
Each chair is 50,000 riel, about $12. The rubbish bins are $15, the flower
containers are $10. The rubbish bins sell well: the parents buy them and put
them out the front of their house. We spray paint the rubbish bins
“Made by the victim” in white paint.[187]

When asked
if he was able to use these skills outside Orgkas Khnom, Vicheaka replied:
“I don’t have money to do this outside Orgkas Khnom. I have no
transport to find customers. I need money for tools, for materials,
communication with buyers. They did not give me this [support] when I left
[the center].”[188]

Forced military drills

In addition to a strict regime of physical exercises and
laboring, former detainees also report that they are drilled to march in
military formations. M’noh, age 16, described the military drills at the
Social Affairs “Youth Rehabilitation Center” in Choam Chao:

We would march and hold our hands like we carry a gun. Each
movement would be consistent. At the time, we would sing the national anthem.
[The exercise] was like carrying [a] gun, like a military parade. We had to
salute the commanders. You had to say ‘Yes! I accept the order!’
It’s like a physical exercise: when you do it, you sweat... They would
call ‘One, two, one, two...’ When they call one, the left
foot lifts, then two the right foot. Every step must be consistent with those
in the front and back. They didn’t tell us why [we had to do this].[189]

Puth described the military exercises in the Orgkas Khnom
center:

We had to stand at attention, stand at ease, turn left,
turn right, march like on parade, salute the officers. If you turn the wrong
way then you are slapped on the face... [or] if they called
‘Attention’ and you turned, then you are slapped.[190]

Former detainees are under no illusions about the usefulness
of such military drills. According to Angkear, “We had to learn
military drills... It was a waste of time... I just followed what they told me,
like turn left, turn right, turn around, stand to attention...”[191]

As with the daily physical
exercises, participation and correct performance of the drills was enforced by
beatings.

Group classes

Detainees may also attend group classes: in some centers
this is once a day, in other centers it may be twice a day (a “Good
Morning” class and a “Good Afternoon” class) while in others
the classes are much less regular. The classes cover education on drug issues,
lectures demanding that detainees should change their behavior, as well as
self-criticism and criticism of others.

Kuhear, a former detainee of a military police center,
describes his daily classes:

A military policeman was the teacher. Sometimes, when he
was busy, we missed a class. This was from 2-4 p.m.... I know some
articles [of the drug law]. ‘Drugs can cause physical, mental and
spiritual impact. It causes impact on the liver, it causes central nervous
system damage.’ We learnt this from [the staff member]. He talked
about the law, if someone causes battery, injury to others, they could be
imprisoned from 1-3 years. They also explained about the impact of drug use.[192]

Kanha describes the classes he attended in the Orgkas Khnom
center. The “Good Morning” class was led by a staff member, while
the “Good Afternoon” class was led by a room captain. Both talked
about the effects of drugs and the need for detainees to “correct”
themselves.

In the ‘Good Afternoon’ class the room captains
tell the new people [the same information as in the “Good Morning”
class]. If someone keeps silent and concentrates on what he says, then
it’s ok. If someone does not listen and concentrate, he could be beaten.
[The room captain] would repeat what [the staff] said, like ‘Outside you
used drugs, now you should stop. You should find a job and not beat your family.’
He said the same thing every day... those who did not listen to him would be
beaten.[193]

Food

Former detainees complained to Human Rights Watch about the
quality and quantity of the food provided to them. Detainees generally were
given food three times per day, but several detainees reported they were
provided insufficient amounts of food and that they were often hungry. The food
provided was sometimes rotten or insect-ridden. It also appears to have been
grossly deficient both in nutritional and caloric content, particularly given
the exercise and labor regime in the centers. Reports of insufficient food were
more common among detainees who had been admitted without their parents paying
for their arrest and detention. Detainees reported symptoms such as
numbness and swelling, which are consistent with diseases caused by nutritional
deficiencies.

Sarika described the food as “awful. We had porridge
in the morning, mixed with fly’s eggs, even some worms....”[194]
In Srokaneak’s words,

Once or twice a week they would make porridge [for
breakfast]. Then there was rice and soup... We had this for lunch and dinner.
It was tasteless, more liquid than vegetables. I could never get full. You were
full for a short period of time then you start starving again.[195]

For detainees whose parents paid for their detention,
parents would also supplement the food rations provided by the centers.
According to Putrea,

The soup was like pig’s food. In the morning, for
breakfast, we had porridge and salted soybeans. We felt hungry just sitting
inside the room. For lunch we had steamed rice and sour soup... the vegetables
inside the soup were indescribable. We ate only the vegetables we planted, like
morning glory [and] green beans. The vegetables were not good. Sometimes the
vegetables had worms and the worms would float in the soup. Dinner was the same
[type of] food... The rich kids had separate food: they had dried sardines,
noodles, beef, chicken. Parents bought this from outside and gave the raw food
to the cooks in the center. The parents paid money for cooking.[196]

Makara’s parents sent him rations of food during his
detention. He said that detainees who ate only the food provided by the center
would beg him for his food.

Those [detainees] who have no parents find it difficult.
They watch you eat food. The food rations in Orgkas Khnom are not enough for
them: they don’t have enough to eat. Those who have parents have instant
noodles or candy or cakes for snacks... The other [detainees] felt hungry when
they saw people eating snacks. Some of those who were arrested would sit and
stare at me eating, so I would share [my food]. They said ‘Oh brother,
can I share food with you?’ so I passed it on.[197]

A number of former detainees mentioned symptoms of
“numbness and swelling” among detainees. Atith explained how it was
at the Orgkas Khnom center:

My leg was swollen, all my body swelled up, even my face.
This was because of tasteless food... Those who have family to bring them food,
they have no swelling. But without food from the family, people swell up... You
know the food is vegetable soup every day... Because I had no other food to eat
[from my parents], I had only soup. Many people like me, who have no family,
swell up. With so much swelling, I could not walk. I felt tired.[198]

Pok reported similar symptoms while detained at the
provincial police center in Borvel:

First I started to be numb in my leg and I tried to stand
up but could not. Each time I wanted to stand up I used my hand to pull me up
by the window or the door. I still could not walk... As many as 20 people had
this problem [when I was there]...[199]

Angkear, who was detained for an extended period in 2008 in
the Orgkas Khnom center, reported the same symptoms of numbness and swelling during
his period of detention. He was limping when he was interviewed by Human Rights
Watch two months after his release. He explained:

The soup was not good. The kitchen was very dirty and the
food tasteless. There was no fish in the soup and in addition the rice was bad
quality. My leg went numb... Inside the center there are many people who
have swollen legs because the food is bland. The food they cook is difficult to
eat. Outside [the center] you would see this food and not eat it... It was very
dirty. One man had not only his leg but also his face, his whole body,
swollen... Now I can’t move my foot. The swelling has gone but my foot
and toes remain numb.[200]

One hypothesis is that these symptoms of “numbness and
swelling” indicate cases of beri-beri. Beri-beri is a disease affecting
the nervous system caused by a lack of thiamine (vitamin B1). Advanced cases may
cause death. A doctor working with a UN agency visited three centers in mid
2008. The doctor said that some 10-25 percent of detainees in all three centers
he visited self-reported ‘numbness and swelling’, which in some
cases was severe enough to interfere with the abilities to walk and to stand
upright. The doctor hypothesized that the numbness and swelling might be
beri-beri.[201]
Although a clinical diagnosis of beri-beri was not possible in the
circumstances, he told Human Rights Watch: “I observed high rates
of reported “numbness and swelling” which seems consistent with
thiamine deficiency and is a plausible cause given the [poor] dietary provision
in the centers.”[202]

Applicable standards

Drug treatment

The World Health Organization considers that substance
dependence is not a failure of will or of strength of character but a chronic,
relapsing medical condition with a physiological and genetic basis that could
affect any human being.[203]WHO and UNODC note that:

[t]he same standards of ethical treatment should apply to
the treatment of drug dependence as other health care conditions. These include
the right to autonomy, and self determination on the part of the patient, and the
obligation for beneficence and non maleficence [do good/do no harm] on behalf
of treating staff.[204]

Forcing people into treatment
as a matter of course and en masse involves numerous violations of the
human rights of those subjected to these measures.

The Committee on Economic,
Social and Cultural Rights (CESCR) has stated that a state’s health
facilities, goods and services should be available, acceptable, accessible and
of good quality. [205]However, as WHO and UNODC note, “neither detention nor
forced labor have been recognized by science as treatment for drug use
disorders.”[206] Similarly,
neither forced physical exercise nor military drills have been scientifically
recognized as forms of treatment. Forcing
people to undergo supposed “treatment” that is not evidence-based would
violate the requirement that health
facilities, goods and services should be culturally and ethically acceptable, scientifically
and medically appropriate, and of good quality.

When supposed
“treatment” and “rehabilitation” involves detention,
such a systemalso violates a number of other rights, such as
freedom from arbitrary detention. Further, when supposed
“treatment” and “rehabilitation” involves compulsory
labor which does not benefit the detainees, or is abusive such a system
violates the prohibition on forced labor as enshrined in various
international human rights instruments.[207]

The ban on forced labor in
international law does not extend to “[a]ny work or service exacted from
any person as a consequence of a conviction in a court of law, provided that
the said work or service is carried out under the supervision and control of a
public authority and that the said person is not hired to or placed at the
disposal of private individuals, companies or associations.”[208] However, people detained in Cambodia’s
drug detention centers have not been ordered to perform labor as a part of
their sentence. In addition, some people report working on apparently
private projects around Phnom Penh, or constructing buildings owned by center staff.

The UN Minimum Standard Rules for the Treatment of Prisoners
provides that work undertaken be to a
prisoner’s benefit, and that it not be subordinated to the purpose of
making a financial profit for the institution.[209]

Under the ICCPR, governments must provide “adequate
medical care during detention.”[210] Former
detainees reported to Human Rights Watch that they were forced to perform
grueling physical exercises, to work and to march in military formation. They
also reported severe punishment for not being able to complete these tasks.

Such elements of supposed “treatment” and
“rehabilitation” may also constitute inhuman or degrading treatment
or punishment. For example, the UN Special Rapporteur on Torture has stated
that the re-education through labor system in China

and similar methods of re-education in prisons, pretrial
detention centres, and other institutions... can also be considered as a form
of inhuman or degrading treatment or punishment, if not mental torture.[211]

Where systems of supposed drug
“treatment” and “rehabilitation” force people into
treatment as a matter of course and en masse, such systems violate the
international human rights standards that medical treatment must be based on
free and informed consent. The Special Rapporteur on the Right to Health has
stated that:

Informed consent is not mere acceptance of a medical
intervention, but a voluntary and sufficiently informed decision, protecting
the right of the patient to be involved in medical decision-making, and
assigning associated duties and obligations to health-care providers. Its
ethical and legal normative justifications stem from its promotion of patient
autonomy, self-determination, bodily integrity and well-being.[212]

The right to health includes
the principle of treatment following informed consent. The CESCR has
interpreted Article 12 to include “the right to be free from...
non-consensual medical treatment and experimentation.”[213]

Indeed, scientific research
from other countries has questioned the effectiveness of compulsory drug
treatment. Some research suggests that a
lack of internal client motivation in treatment may undermine positive
outcomes.[214]Specifically
with relation to treatment for methamphetamine dependence, some research has
shown that compulsory treatment has been associated with higher rates of
relapse than voluntary treatment.[215]Independent reviews of Vietnam’s
system of compulsory drug treatment have found
that it is not cost effective and that the rate of relapse to drug use for
former detainees is around 90 percent.[216]

The CESCR has noted that a
state’s obligation to respect the right to health includes the obligation
to refrain from applying coercive medical treatments unless on an exceptional
basis for the treatment of mental illness or the prevention and control of
communicable diseases.[217]

Such exceptional cases should
be subject to specific and restrictive conditions, respecting best practices
and applicable international standards.[218]As WHO and UNODC note, “only in
exceptional crisis situations of high risk to self or others, compulsory
treatment should be mandated for specific conditions and periods of time as
specified by the law.”[219]

In the absence of clinical
opinions by professional healthcare professionals, Cambodia’s system
forces people to undergo supposed “treatment” and
“rehabilitation” regardless of whether there is an actual lack of
capacity on the part of the person to consent to treatment. The system
ignores an individual’s treatment needs (if any) and therefore cannot be
said to be justified by a demonstrable benefit from the proposed intervention.
The system denies an individual the opportunity to cease or modify his or her
treatment plan and fails to review the ongoing necessity of treatment. Because
of such failings, there are no procedural guarantees that the compulsory
intervention will not be provided for longer than strictly necessary.

As a form of diversion from the criminal justice system,
where the use and/or possession of drugs remains a criminal or administrative offense,
such as is nominally provided for under Cambodia’s drugs law, great care
must be taken to ensure that an individual’s autonomy is respected. As
WHO and UNODC note, “the patient is entitled to reject treatment and choose
the penal sanction instead.”[220]

WHO notes that during
withdrawal:

Appropriate supervision is needed and medical services
should be available, especially in the presence of confusional states, cerebral
seizure or hazards as a consequence of poor nutritional condition. Adequate
monitoring has an essential part in the management of withdrawal state.
Pharmacological treatment and other methods... can be used to relieve pain,
unrest, sleeplessness or other symptoms. Decreasing dosages of a substitute
substance may be administered, especially in cases of... opioid dependence.[221]

Non-discrimination in drug treatment services

A noted above, there are no drug treatment services in
Cambodia tailored for women and girls. Human Rights Watch does not believe that
opening a drug detention center for women is the appropriate policy response to
this lack of drug treatment services. Rather, Cambodia should be guided by
informed policy positions about how best to meet women’s needs to
effective drug treatment services.

According to the CESCR, states must take special care to
ensure that women and girls have equal access to health services.[222]
Men’s and women’s clinical needs with respect to drug dependence
treatment may differ substantially. UNODC considers that programs that provide
special services for women are associated with much better treatment outcomes
for this population.[223]
According to UNODC, drug dependence treatment for women can be made more
effective by the following programmatic responses, among others:

Development of a
comprehensive programthat is non-judgmental and
non-punitive. Attention to relationships, trauma and concurrent disorders
is essential for successful service provision.

Provision of community-based
servicesis cost-effective, less intrusive and accommodates
women who have difficulties in entering residential services.

Provision of facilities and
care for pregnant and parenting womenthat is
multidisciplinary, comprehensive and coordinated contributes to improved
retention and outcomes for mothers and newborns.

UNODC also
recommends coupling treatment services with child care and social services and
support (such as assistance with job and training opportunities, family therapy
and assistance with safe housing).[224]

Food

Article 10 of the ICCPR
requires that anyone deprived of their liberty be treated with humanity and
dignity, which includes that they be detained in humane conditions.
Particularly harsh conditions of detention, including deprivation of food,
constitute inhuman conditions of detention in violation of the ICCPR.[225]

The UN Minimum Standard Rules
for the Treatment of Prisoners provides: “Every prisoner shall be
provided by the administration at the usual hours with food of nutritional
value adequate for health and strength, of wholesome quality and well prepared
and served.”[226] This standard has been cited with approval by the UN
Human Rights Committee when examining the minimum standards that a state must
observe in respect of those deprived of their liberty “regardless of a
state party’s level of development.”[227]

Specific populations

Children

You know, children have the right to complain about this! I
want those children out of those centers, so they can have freedom like me now.

—Chambok, 17 years old, former detainee of the Social
Affairs “Youth Rehabilitation Center” in Choam Chao [228]

Cambodia’s drug detention centers hold a large number
of children. Indeed, some of the designated drug detention centers—the
Social Affairs centers at Choam Chao and in Kandal province—are nominally
“Youth Rehabilitation Centers.” As noted above, in 2008 just under
one quarter of detainees in government drug detention centers were aged 18 or
below. Of these, 104 children were younger than 15. In 2008, 116 detained
people were classified as “street children.”[229]Children are arrested and detained without
legal authority. Children are detained in the same sleeping quarters as adults.
There is an absence of appropriate treatment, education and recreation services
at the centers. Human Rights Watch was told that detainees of the Choam Chao
“Youth Rehabilitation Center” were given electrical shocks, beaten
and forced by “cats” to dance naked.

Many street children are arrested by police or other
authorities in street sweeps and taken directly to detention centers without
any legal authority whatsoever. Chambok, 17 years old, explained the process of
his arrest and detention:

[Those who arrested me] are staff from Social Affairs...
They snatched me and threw me in the truck. In the truck there was a cage.
There was a logo of Social Affairs [on the truck]... My friends were in the truck,
more than five of us... They arrested us at 4 or 5 p.m. and then took us
straight to Choam Chao [detention center]. They didn’t tell me why they
arrested me: I wonder this too... I never saw a lawyer... They simply put me
into the truck and I arrived at Choam Chao [center] at 6 p.m.[230]

Children and adults are commonly detained together. In the
course of researching this report, Human Rights Watch interviewed six adults
(i.e. over 18 years old) who had been detained in the Social Affairs
“Youth Rehabilitation Center” in Choam Chao. Other centers also
detain children and adults together. According to Sao, age 24, and a former
detainee of Orgkas Khnom center:

In my room, there were about four children, 13-15 years
old. They were there for sniffing glue. They were arrested. They work like us.
They do military drills like us. They sleep in rooms with adults.[231]

Similarly, Trach, 27 years old, reported that there was no
separation of children and adults in the Siem Reap civilian police center:

The youngest [in the center] was 12 or 13... they were glue
sniffers. There were about seven or eight kids under 18. They slept with us.
Normal kids slept with the crazy people.[232]

Kakada, age 28, described the Social Affairs center at Choam
Chao as “a center to bully children.” He reported that the children
at the center were given the same military training as the adults:

There are small boys and they bully them like soldiers.
They beat them and slap them. The “cats” and the guards [do this].
They are trained like soldiers but I feel such pity because they look like my
younger brother. Sometimes I burst into tears with pity. They train them like
soldiers to harden their bodies. The guard gave military orders, like
turn left, turn right. The training is to make them strong, to make them stay
away from drugs... If they fell out of line while rolling [on the ground], the
guards kicked them in the head. One boy rolled but did not roll in a straight
line... The guard said ‘You, boy, you did not do it.’ He
asked the boy to stand up and kicked the boy. He fell back two meters. The
guard said, ‘If you cry, I will do it again.’ The boy cried.[233]

Makara, age 25, a former detainee of the Orgkas Khnom
center, explained:

[Children] were treated the same [as other detainees]: 100
percent [of detainees] get soldier training, military parades, saluting staff,
clearing the grass, hoeing the ground, cleaning the toilet, raising cows and
ducks...[234]

Kanha, age 35, a former detainee of the Orgkas Khnom center,
explained:

There were people who were 10, 12, 13 years old, maybe
about 10 of them [in the center]... Some slept in a different room. But
there were 3 boys—one 10 [years old], one 12 [years old] and one 13
[years old]—in my room. They did the same work [as other detainees]:
hoeing the ground, go to [Good Morning] class, have military training.
Sometimes they were beaten, if they were guilty [of breaking internal rules]. I
saw this. Regardless of being a boy or a man, if they made a mistake they were
beaten.[235]

Much of the torture and physical abuse by staff described
above were reported to Human Rights Watch by children. Human Rights Watch
interviewed children formerly detained in the Social Affairs “Youth
Rehabilitation Center” in Choam Chao who reported horrific treatment at
the hands of the staff and detainees. Despite being a nominal rehabilitation
center for youth, the guards have access to electrical batons. Kakada, 28 years
old and a former detainee of the “Youth Rehabilitation Center” in
Choam Chao, witnessed a fellow detainee in that center being shocked as
punishment for attempting to escape:

The guards outside the center have electrical batons. When
someone tries to escape the ‘cats’ scream out to those guards with
electrical batons.... One man ran and a guard shocked him until he fell on the
ground. He lost consciousness.... In that place they think only of
beating.[236]

Tonle, 16, another former detainee at the Social Affairs
“Youth Rehabilitation Center” in Choam Chao, described being forced
to dance naked by the “cats”:

You know, when [the ‘cats’] got drunk they
asked all the kids to take off all their clothes and dance. It happened once.
Everybody had to do this. It was inside the room. They played karaoke song[s]
on the mobile phone. It was about 8 or 9 at night.... More than 20 had to
take off their clothes and dance, for about half an hour. If you didn’t
take off your clothes you would be beaten.[237]

Chambok, 17, told of being forced to work by being
beaten when he was sick:

[In Choam Chao] I cleared the grass. You know if someone
does not work you have to go to meet the guard and get the ‘ox’s
penis’ [a police baton] three times. They beat me two times because I was
sick. They said ‘No, you work!’ I was shivering [at this
time], I had malaria.[238]

Khal, age 16, describes daily beatings by “cats”
at Choam Chao:

[The ‘cats’] beat me to ‘welcome’
me, but after the welcome they still beat me every day. They used their hands.
They said I was a rude boy, that my face was a rude face. I did not do anything
wrong. [A ‘cat’] punched me in the chest, many times. [The
‘cat’] ordered his subordinates to beat me. Nobody dared to tell
the guards or else [the ‘cat’] would beat us. I didn’t try
and tell the guards because I was afraid of being beaten by [the
‘cat’].[239]

Extract from song in
Choam Chao “Youth Rehabilitation Center”

This song
was taught to detainees of the Social Affairs “Youth Rehabilitation
Center” in Choam Chao. Detainees reported having been forced to sing it
two mornings a week.

On the
first imprisonment eating the ox’s penis three times [being beaten with
a baton three times] is considered as exercise;

Baby, as I
beg for money

Baby, as I
beg for money

I will
promenade you in Choam Chao.

Choam
Chao, a very happy place

where
handsome boys

sit and
uproot grass.

Babe, this
is Choam Chao center

Babe, this
is Choam Chao center

sitting
and uprooting grass seven times a week.

Abuses against children were reported to Human Rights Watch
in centers other than the Social Affairs center in Choam Chao. A former
detainee, Russey, 17 years old, describes being beaten by the military police
in the center in Battambang to mark his release from the center:

The military police beat me. They used the black
‘ox’s penis’ [a police baton] on my bum... The trainer said
‘This kid is released today so let me give you a beating.’
[Then he asked] ‘Will you rehabilitate yourself? Will you stop
[using drugs]? Do you have work?” Then he gave [me] another
beating.’[241]

Chamnauth, age 15, was one of the few females interviewed by
Human Rights Watch who had been detained in a center other than a Social
Affairs center. Like many of her male fellow detainees, she reported she was
beaten:

I had to do exercise too [as well as the boys and men]. I
did cooking [as labor]. If I made a little mistake, I was beaten. I made a
mistake in putting the wrong ingredients in the soup. The chef, a staff, beat
me. They whipped my hand with a stick.[242]

Mentally ill

They arrested even crazy people...They were just arrested
and thrown in the truck. There were about four [mentally ill] people in the
center... They do the work like cleaning the grass and carrying water and
watering vegetables. They can not communicate well, that’s why they get
beaten up.

—Kakada, age 28, a former detainee of the Social
Affairs “Youth Rehabilitation Center” in Choam Chao[243]

In practice, the government drug detention centers also
function as a convenient means of removing people with apparent mental illnesses
from the general community. Human Rights Watch interviewed former detainees who
described appalling physical violence against people who appeared to suffer
mental illnesses.

Sao, a former detainee of the Orgkas Khnom center, explained
that the center is used to detain people who are apparently mentally ill.

There are crazy people [detained] there. They are not drug
users. They don’t know what is wrong and right, they speak during the
night, they eat on the ground. They are ‘brainless’ people. They
are beaten if they do no labor: after they are beaten, they work. Their
families put them there. Some were arrested while they were wandering in the
markets.[244]

According to a draft report of a joint assessment of the
centers conducted by WHO and the Cambodian government:

There is no provision of mental health services in the
centers. The center in Siem Reap was holding patients who were not drug
dependent. It seemed that some of their patients were mentally ill and had been
placed in the center after being ‘picked up’ by police or other
authorities and brought to the center.... Centers do not effectively assess
levels of mental health and so it is likely that a population of participants
suffer from mental health issues.[245]

Human Rights Watch received reports of cruel and inhuman
treatment of people with apparent mental illness. Kakada witnessed one man with
an apparent mental illness being severely beaten.

[The staff and other detainees] kick the crazy people
because they [mentally ill people] don’t know anything. One crazy man,
the guard asked him to use the stick [as a shoulder pole] to carry the water,
but the crazy man used the stick to beat someone else because he didn’t
know better. The guard snatched the stick and beat him all over until he was
seriously injured. We could not help the crazy man: if we tried to help him we
would be beaten. The guard beat him too much, on the back, until he vomited
blood. He beat him until the man fell on the ground and the stick was broken...[246]

Kuhear told of one beating of an apparently mentally ill man
by a room captain, on the direct orders and in the presence of military police.

Four military police stood watching the beating of [a
detainee] by the room captain. They said ‘Room captain: beat him until he
gets scared!’ [The detainee], because he has a little bit of a mental
problem, ate half a bar of soap. ‘Beat him to stop him from eating soap
again, beat him to make him spit it out!’ [The first military police
officer], the person in charge of work and [the second military police
officer], the Deputy Commander of the center said this. Then the room captain
beat [the detainee], kicking, punching, kicking with the heel into [the
detainee’s] back. At first, the military police were angry [and] then
they were laughing.[247]

Mesa said he witnessed the beating of a man with an apparent
mental illness:

One [room captain] beat a man who was crazy.... He had two
sticks he hid at the head of his bed. One stick was wooden, the other was cane.
He asked people to take off the crazy man’s pants and beat him. His
buttocks were red. He was a crazy man: he was alone, so quiet. Outside
the center he was a normal man but inside the center he became crazy: maybe
people beat him a lot.[248]

Applicable standards

Detention of children as a last resort

The UN Convention on the Rights of the Child (CRC)—a
binding international treaty to which Cambodia is a party—states that any
arrest, detention, or imprisonment of a child must be in conformity with the
law and can be done only as a “measure of last resort.”[249]
Moreover, children deprived of their liberty have the right to challenge the
legality of their detention before a court or other competent, independent and
impartial authority, and are entitled to a prompt decision on any such action.[250]
This means that in general a child should not be detained unless it is
adjudicated that he or she has committed a violent act against someone or is
persistent in committing other serious offenses and there is no other
appropriate response.[251]

The UN Committee on the Rights of
the Child—a body of independent experts empowered with interpreting the
CRC and examining whether countries are in compliance with it—has
highlighted the need for a range of alternatives to avoid restriction of
liberty for children who use drugs.[252] The
Committee has expressed concern at non-criminal responses to children who use
drugs which are stigmatizing or involve depriving children of their liberty or
other civil rights, such as placing children in closed rehabilitative centers.
Indeed, the Committee has advocated for the development of non-institutional
forms of treatment of children who abuse drugs and for making the placement of
children in an institution a measure of last resort. In addition, children
living in such institutions should be provided with basic services such as
health, education and other social services and maintain contact with their
family during their stay. Finally, the Committee has called for the setting of
clear standards for institutions and a provision of periodic reviews of the
placement of children.[253]

Lack of age-specific programs or services/No separation of adults and
children

The detention of persons under age 18 in the same facilities
as adults is prohibited under international human rights law.[254]
The Committee on the Rights of the Child has noted that children placed in
institutions for the purpose of drug treatment are guaranteed at least the same
minimum standards as any child deprived of his or liberty.[255]
Cambodia’s prison regulations require the separation of adult and child
prisoners.[256]

Detention facilities should seek to detect and should treat
any physical or mental illness, substance abuse or other condition that may
hinder the integration of children into society and should adopt specialized
drug prevention and rehabilitation programs administered by qualified
personnel. These programs should be adapted to the age, sex and other
requirements of the juveniles concerned, and detoxification facilities and
services staffed by trained personnel should be available to drug- or
alcohol-dependent juveniles.[257]

Torture and cruel and inhuman treatment

Just as with adults, all children detained must be treated
with dignity and there is an absolute prohibition on subjecting a child to
torture or to cruel, inhuman or degrading treatment or punishment.[258]The Special Rapporteur on torture has noted:

Unlike most adults, children can be deprived of their
liberty in a variety of legal settings other than those related to the criminal
justice system and are thus reported to be particularly vulnerable to some
forms of torture or ill-treatment in an institutional environment.... Unlike
detention within the justice system, which in most cases will take place for a
predetermined period of time, children are sometimes held in such institutions
and subjected to cruel and inhuman or degrading treatment without time limits
or periodic review or judicial oversight of the placement decision. Such
indeterminate confinement, particularly in institutions that severely restrict
their freedom of movement, can in itself constitute cruel or inhuman treatment.[259]

Degrading treatment includes
treatment that involves the humiliation of the victim or that is
disproportionate to the circumstances of the case. For example, in the cases
above, forcing boys to dance naked and corporal punishment for infringing
center rules violate Cambodia’s obligation to prevent cruel, inhuman and
degrading treatment.

The draft Criminal Code
provides that “torture and barbarous acts” are punishable with
imprisonment for between seven and 15 years. Where committed on “a person particularly vulnerable due to his/her
age” or “on a person particularly vulnerable due to his/her
sickness or disability while his/her conditions are apparent or known to the
perpetrator” then the punishment is between 10 and 20 years imprisonment.[260]

Mentally ill

Under international human rights law, people with a mental
illness are protected from torture or cruel, inhuman, or degrading treatment or
punishment. International human rights law also affirms the separate right to
health, which requires appropriate mental health care, to the extent feasible,
for all people, including the right to proper treatment for mental illness.

The United Nations “Principles for the Protection and
Care of People with Mental Illness” establish that involuntary treatment
occurs only in cases that satisfy strict criteria. The Principles establish
that a patient’s right to medical treatment only with fully informed
consent can be limited “only after a fair hearing by an independent and
impartial tribunal established by domestic law.” The tribunal must be
satisfied that the “patient lacks the capacity to give or withhold
informed consent to the proposed plan of treatment or that, having regard to
the patient’s own safety or the safety of others, the patient
unreasonably withholds such consent” and that the proposed treatment plan
is “in the best interests of the patient’s health needs.”
Involuntary admission or retention must be initially for a short period (as
specified by domestic law) for observation and preliminary treatment, pending
review. In cases of involuntary treatment, such treatment shall not be
prolonged beyond the period that is strictly necessary for this purpose.
Further, the patient shall have the right to be treated in the least
restrictive environment and with the least restrictive or intrusive appropriate
treatment.[261]

VI. Conclusions

There is no doubt that illegal drug use raises complex and
multifaceted challenges for public policy makers. Traditionally, states’
policies on drug use have focused on both supply and demand reduction of drugs.
Increasingly, states are incorporating public health perspectives to reduce the
immediate harms of drug use, such as the spread of HIV and other blood borne
diseases among people who use drugs. Reducing the supply of, the demand for,
and the immediate harms associated with drug use are all clearly elements of a
state’s policies on drugs, wherever drug use poses a serious threat to
public health. But great care must be taken to ensure that the nature and
implementation of supply and demand reduction polices are consistent with
states’ human rights obligations.

Drug dependence is a chronic, relapsing disease. Drug users,
both in and out of detention, have a right to access drug dependence treatment
that is medically appropriate and comports with international standards. According
to UNODC and WHO, “[t]he human rights of people with drug dependence
should never be restricted on the grounds of treatment and
rehabilitation.”[262]
However, in Cambodia, people who use drugs are treated as though they have lost
their human rights.

As “rehabilitation” or “treatment”
for drug dependence, such centers are failures. Compounding the therapeutic
ineffectiveness of detention itself, detainees are forced to perform activities
that have no scientific basis for treating drug dependence, such as forced
physical exercises, forced labor and forced military drills. As one NGO staff
member with considerable experience working on drug issues in Cambodia
explained to Human Rights Watch, “[In the
centers] there is a total lack of understanding of addiction as a psychological
and social process.”[263] There
are no indications that the existing system of compulsory drug detention
centers is reducing the number of Cambodians who use drugs.

Rather, the drug treatment centers appear driven by
motivations of social control, retribution for the perceived moral failure of
drug use, and profit. From the moment they are arrested to when they are
finally released from the centers, detainees are subjected to sadistic
violence. Violence is perpetrated on detainees who are children or mentally
ill, regardless. Staff of centers can use electric batons, whip and beat
detainees with impunity and order fellow detainees to do the same. In many
instances, center staff exploit the detainees for their own benefit, whether
that be forcing detainees to labor or coercing them to donate their blood. The
detention of people in these centers and their subjection to such treatment is
in violation of all applicable international standards.

In
view of the widespread abuses against detainees, the Royal Cambodian Government
should immediately close Cambodia’s drug detention centers. The Royal
Cambodian Government should investigate and take legal action (including
criminal prosecution) against the perpetrators of torture, cruel and inhuman
treatment, arbitrary detention and other human rights abuses and criminal acts
in Cambodia’s drug detention centers. People who are currently being
unlawfully detained should be released; their continued detention cannot be
justified on legal or medical grounds. The need for voluntary, community-based
drug dependency treatment remains as urgent and pressing as ever for the health
and human rights of people who use drugs in Cambodia.

VII. Acknowledgements

This report was researched and written by a Human Rights Watch staff
member. It was edited and reviewed by Joseph Amon, Director of the Health and
Human Rights division, and Rebecca Schleifer, Advocacy Director in the Health
and Human Rights division. Aisling Reidy, Senior Legal Advisor; Iain Levine,
Program Director; and Sara Colm, Senior Researcher in the Asia division, all
with Human Rights Watch, also reviewed the report, as did Jason Barber.
Production assistance was provided by Andrea Cottom, Mignon Lamia, Grace Choi,
Anna Lopriore, and Fitzroy Hepkins. Human Rights Watch would also like to
thank Guy Jarman for the design and creation of the map.

Human Rights Watch is deeply grateful to the many individuals who shared
their knowledge and experiences with us. Without their testimony this report
would not be possible.

Annex:
Correspondence with the Royal Cambodian Government

[1]
Human Rights Watch interview with M’noh, Phnom Penh, June 2009. The
identity of interviewees has been disguised with randomly-selected pseudonyms
and in some cases certain other identifying information has been withheld, to
protect their privacy and safety.

[6]An additional eight interviews with former detainees
were not included in this report, either because the interviewees had been
detained in drug
detention centers prior to the three year limitation period of this research or
because the interviewees were unable to recollect with sufficient clarity when
they had been detained. “Child” as used in this
report, refers to anyone under the age of 18. Convention on the Rights of the
Child (CRC), art. 1, adopted November 20, 1989, 1577 U.N.T.S. 3 (entered into
force September 2, 1990). Cambodia ratified the CRC on October 15, 1992.

[7]
The Center in Prey Speu also works closely with the Department of Social
Affairs, Vocational Training and Rehabilitation of the Phnom Penh
Municipality.

[12]
“Report from the National Residential Treatment Center Minimum Dataset:
2008,” Drug Information Center, National Authority for Combating Drugs,
presented at DHA Technical Working Group Meeting, NAGA World Hotel, June 4,
2009 (copy on file at Human Rights Watch).
“Treatment,” as used in this report, is defined as “the
process that begins when psychoactive substance users come into contact with a
health provider or other community service, and may continue through a
succession of specific interventions until the highest attainable level of
health and well-being is reached. Treatment and rehabilitation are defined as a
comprehensive approach to identification, assistance, health care, and social
integration with regards to persons presenting problems caused by the use of
any psychoactive substance. These definitions include the notion that substance
users are entitled to be treated with humanity and respect.” (WHO Expert
Committee on Drug Dependence, Thirtieth Report: WHO Technical Report Series
873, 1998, http://whqlibdoc.who.int/trs/WHO_TRS_873.pdf.) In Cambodia, because
detainees do not come into contact with a health provider and there is little
or no “identification, assistance, health care, and social
integration” inside such centers, it would be misleading to refer to
Cambodia’s centers as either treatment or rehabilitation centers. This
report refers to Cambodia’s centers as “drug detention
centers”.

[13]Given
that the NACD has published inconsistent lists of the number of government drug
detention centers, these figures may be unreliable and the actual number of
detainees might be higher. Drug
Information Center, Secretariat General, National Authority for Combating
Drugs, “Summary
Report of Drug Data, 2008,” Phnom Penh, April 2009, unpublished (copy on file at
Human Rights Watch); Data collected from July-December 2007 describe a similar
situation to the 2008 figures. The majority of people admitted (50.7percent) were
aged from 19-25 years old. Over 9percent were less than 16 years old, and almost 22
percent were aged 16-18. The most preferred drugs were methamphetamine (47
percent) and crystal meth (34 percent). Just 2.3 percent of admissions
were voluntary, while 51.4 percent were “family” admissions and
46.4 percent were “judicial admissions.” 1.1 percent of admissions were female. The number of
people admitted from July to December 2007 was 740. See National Authority for
Combating Drugs, ”Report on Illicit Drug Data and Routine Surveillance
Systems in Cambodia 2007,” June 2008, pp 74-75.

[14] Note the data does not reflect use of different types
of drugs by the same person, which is a common feature of drug consumption in
Cambodia.

[15]“Report from the National
Residential Treatment Center Minimum Dataset: 2008,” Drug Information
Center, National Authority for Combating Drugs, presented at DHA Technical
Working Group Meeting, NAGA World Hotel, June 4, 2009 (copy on file at Human
Rights Watch).

[20]Circular No. 03.SR, Royal Government of Cambodia,
Phnom Penh, October 23, 2006.

[21] The same Circular states that “[the] Ministry
of Health shall create a drug addict treatment unit at the national level in
Phnom Penh, arrange consultation service at provincial-municipal and district
referral hospitals to advice [sic] and cure drug addicts sent to the hospitals
by their parents, develop technical standards to control drug addict treatment
services in communities’ centers and eliminate treatment places that are
not authorized by the Ministry of Health.” These activities have not been
completed, nor has the Ministry of Health closed centers that are not
authorized by it.

[22]For example, the NACD’s 2007 “Report on
illicit drug data and routine surveillance systems in Cambodia 2007”
lists 13 government detention centers for drug dependence (although this lists
contains at least one center that claims to be an NGO.) Meanwhile the
NACD’s 2008 annual report lists 10 centers. The 2007 list does not
include a Social Affairs “Youth
Rehabilitation Center” in
Kandal province that appears on the NACD’s 2008 list (despite the fact
that this center was operational during the period covered by the 2007 report.)
However the 2007 list does include a military police center in Sihanoukville
that is absent
from the NACD’s 2008 list, despite no indications that the center has
ceased to be operational. See National Authority for Combating Drugs, “Report
on Illicit Drug Data and Routine Surveillance Systems in Cambodia 2008,”
November 2008, p. 12-13; National Authority for Combating Drugs, “Report
on Illicit Drug Data and Routine Surveillance Systems in Cambodia 2007,”June 2008, pp. 74-75.

[24]
Some people who use drugs also reported being detained at a Social Affairs center
at Koh Kor (also known as Koh Romdoul) within the period covered by of this
report. That center is currently inactive, following the intervention of human
rights organizations in mid-2008. However, it has not been officially closed and
NGOs fear that people who use drugs, the homeless, and other
“undesirables” may again be detained there in the future. As noted
above, testimony from those detained in Koh Kor was not included in this
report.

[25] It is also worth noting that the government-run Khmer Soviet Friendship hospital in Phnom Penh
operates a drug rehabilitation clinic that is slated to shortly begin treating
people who are opioid dependent in a trial of methadone maintenance.

[29] See, for example, World Health Organization Western
Pacific Region, “Assessment of compulsory treatment of people who use
drugs in Cambodia, China, Malaysia and Vietnam: An application of selected
human rights principles,”
2009, pp. 30-34.

[34]See, for example, Cambodian League for the Promotion
and Defense of Human Rights (LICADHO),
“Media statement:
Illegal arrests & Social Affairs centers: time for government action, not
more denials,”
November 9, 2008, http://www.licadho-cambodia.org/press/files/193LICADHOPRActionNotDenials08.pdf
; Asian Human Rights Commission, “The State of Human Rights in Eleven
Asian Nations- 2008”, December 2008, pp. 87-88,
http://www.ahrchk.net/pub/pdf/TheStateofHRin11AsianNations2008.pdf . See also
U.N. Office of the High Commissioner for Human Rights, Role and achievements
of the Office of the United Nations High Commissioner for Human Rights in
assisting the Government and people of Cambodia in the promotion and protection
of human rights , A/HRC/12/41, August 5, 2009, para. 28.

[36]Law on
the Control of Drugs, No. 197/01, 9 December 1996, article 98, para 4. Note that according to the UNODC,
the 1988 Convention requires that illicit possession of controlled substances
must be prohibited, but it does not require criminalprosecution for small quantities. See UNODC,
“World Drug Report 2009,” pp. 166-169.

[39] WHO includes
methadone and buprenorphine on its Model List of Essential Medicines. The Model
List of Essential Medicines is meant to guide health policy-makers in knowing
what medicines are necessary to ensure the health of their populations. See
WHO, WHO Model List of Essential Medicines, revised March 2005, [http://mednet3.who.int/EMLib/index.aspx].

[45] See Legal Drafting Committee, Royal Government of
Cambodia, “Final Draft, Law on Drug Control,” Phnom Penh, March 23, 2009, p. 35-37 (copy on file at Human
Rights Watch).

[46]
Article 7 of the ICCPR provides that : “No one shall be subjected to
torture or to cruel, inhuman or degrading treatment or punishment. In
particular, no one shall be subjected without his free consent to medical or
scientific experimentation.”

[62] For example, Kep Chuktema, Phnom Penh governor, was
quoted in August 2009 as saying “We will establish a new
drug-rehabilitation center for women in Phnom Penh”: “Over 100,000 pills of drug
substances destroyed in Cambodia,” Xinhua news agency, August 20, 2009. The Municipality of Phnom Penh
currently runs the Orgkas Khnom center on the outskirts of Phnom Penh.

[63]“Report
from the National Residential Treatment Center Minimum Dataset: 2008,”
Drug Information Center, National Authority for Combating Drugs, presented at
DHA Technical Working Group Meeting, NAGA World Hotel, June 4, 2009 (copy on
file at Human Rights Watch).
Of the admissions from July-December 2007, 1.1 percent of admissions were
female. The number of people admitted from July to December
2007 was 740: National
Authority for Combating Drugs, “Report on Illicit Drug Data and Routine
Surveillance Systems in Cambodia 2007,” June 2008, p. 75.

[66]
International Covenant on Civil and Political Rights, U.N. Doc. A/6316 (1966), entered
into force on March 23, 1976, acceded to by Cambodia on May 26, 1992. Article 9
provides in part that: 1. Everyone has the right to liberty and security of
person. No one shall be subjected to arbitrary arrest or detention. No one
shall be deprived of his liberty except on such grounds and in accordance with
such procedure as are established by law. 2. Anyone who is arrested shall be
informed, at the time of arrest, of the reasons for his arrest and shall be
promptly informed of any charges against him. 3. Anyone arrested or detained on
a criminal charge shall be brought promptly before a judge or other officer
authorized by law to exercise judicial power and shall be entitled to trial
within a reasonable time or to release.

[67]
In his authoritative commentary on the ICCPR, Manfred Nowak included elements
of injustice, unpredictability, unreasonableness, and non-proportionality in
the meaning of arbitrariness. Manfred Nowak, UN Covenant on Civil and Political
Rights: CCPR Commentary, (2nd rev. ed.). Kehl am Rhein: Engel, 2005 p.225.

[69]
United Nations, Human Rights in the Administration of Justice: A Manual on
Human Rights for Judges, Prosecutors and Lawyers, (New York and Geneva: United
Nations, 2003), Chapter 5: “Human Rights and Arrest, Pre-Trial Detention
and Administrative Detention,” p. 174.

[74]Article 98. Note that the Standard Minimum Rules
for the Treatment of Prisoners
provide that “For the purposes of his defence, an untried prisoner shall
be allowed to apply for free legal aid where such aid is available, and to
receive visits from his legal adviser with a view to his defence and to prepare
and hand to him confidential instructions.” United Nations Standard
Minimum Rules for the Treatment of Prisoners (U.N. Standard Minimum Rules), adopted by the First United
Nations Congress on the Prevention of Crime and the Treatment of Offenders,
held at Geneva in 1955, and approved by the Economic and Social Council by its
resolution 663 C (XXIV) of July 31, 1957, and 2076 (LXII) of May 13, 1977, para 93. Note that Art 12.2 of the UNTAC
code (Provisions Relating to the Judiciary and Criminal Law
and Procedure Applicable in Cambodia During the Transitional Period, September
10 1992) states that detention shall take place in accordance
with the U.N. Standard Minimum Rules.

[75]Under
article 1 of the Convention Against Torture, torture is defined as: “any
act by which severe pain or suffering, whether physical or mental, is
intentionally inflicted on a person for such purposes as obtaining from him or
a third person information or a confession, punishing him for an act he or a
third person has committed or is suspected of having committed, or intimidating
or coercing him or a third person, or for any reason based on discrimination of
any kind, when such pain or suffering is inflicted by or at the instigation of
or with the consent or acquiescence of a public official or other person acting
in an official capacity. It does not include pain or suffering arising only
from, inherent in or incidental to lawful sanctions.”Cambodia ratified
the Convention Against Torture on October 15, 1992.

[77]
The U.N. Special Rapporteur on Torture has noted, “Since it was clear
that rape or other forms of sexual assault against women in detention were
particularly ignominious violations of the inherent dignity and the right to
physical integrity of the human being, they accordingly constituted an act of
torture.” Statement of the U.N. Special Rapporteur on Torture to the U.N.
Commission on Human Rights,” U.N. Commission on Human Rights, U.N. Doc.
E/CN.4/1992/SR.21, Feb. 21, 1992, para. 35.

[78]The
ICCPR's article 7 states, “No one shall be subjected to torture or to
cruel, inhuman or degrading treatment or punishment.” Cambodia
ratified the Convention Against Torture on October 15, 1992. Torture in police custody, including severe beatings
and electrocution with electric batons, has been documented by the Cambodian
human rights group LICADHO in their report ‘Torture in Police
Custody,’ 2003 ,p. 9, www.licadho-cambodia.org/reports/files/372003%20torture%20briefing%20paper.pdf
; ”Prison conditions in Cambodia 2008: Women in prison,” 2008, www.licadho-cambodia.org/reports/files/129LICADHOPrisonWomen2008ENG.pdf . The U.N. Committee on Torture (CAT)
expressed its concern with “The numerous, ongoing and consistent
allegations of acts of torture and other cruel, inhuman or degrading treatment
or punishment committed by law enforcement personnel in police stations and
prisons;” Conclusions and recommendations of the Committee against Torture
: Cambodia. February 2, 2004 CAT/C/CR/31/7 para. 6.

[79]Convention
on the Elimination of All Forms of Discrimination Against Women (CEDAW), G.A.
Res. 34/180, U.N. Doc. A/34/46 (entered into force September 3, 1981). Cambodia
acceded to the treaty on October 15, 1992, arts. 2, 1.

[85]
Ministry of Social Affairs, Veterans and Youth Rehabilitation/ National
Committee for Resolving Vagabond’s Problems, “Instruction on
policies for resolving vagabond’s problems,” Phnom Penh, August 8,
2008, para 6(2); Ministry of Social Affairs, Veteran’s Affairs and Youth
Rehabilitation, “Instruction on the conditions and procedures for
admission, administration and rehabilitation of children and children of the
age of criminal responsibility at the Choam Chao Youth Rehabilitation
Center,” Phnom Penh, August 25, 2006, item 2, (copies on file at Human
Rights Watch).

[92] V. McDonald et al., Summary Findings by Center, Rapid
Assessment of Treatment and Rehabilitation Centers in Cambodia, WHO/NACD-SG/Ministry
of Health/UNAIDS, Phnom Penh, 2008 (unpublished), p. 9, (copy on file at Human Rights Watch). According
to the NACD, “The SDS [“Severity of Dependence Scale”] is a
5-item questionnaire that provides a score indicating the severity of
dependence for different types of drugs. Each of the five items is scored on a
4-point scale (0-3). The total score is obtained by adding the scores for the
five questions. The higher the sum total, the higher the level of
dependence. The questions are concerned with impaired control over drug taking
and with preoccupation and anxieties about drug use.” National Authority
for Combating Drugs, ‘Report on Illicit Drug Data and Routine
Surveillance Systems in Cambodia 2007’, [June 2008], p 77.

[94]“Report
from the National Residential Treatment Center Minimum Dataset: 2008,”
Drug Information Center, National Authority for Combating Drugs, presented at
DHA Technical Working Group Meeting, NAGA World Hotel, June 4, 2009 (copy on file at Human Rights Watch). Similarly, according to NACD data from July-December
2007, 10.6 percent of ‘ya
ma’ users, 16.2 percent of crystal methamphetamine users and 15.4 percent of heroin users admitted
during this period did not reach the threshold of drug dependence. National
Authority for Combating Drugs, “Report on Illicit Drug Data and Routine Surveillance
Systems in Cambodia 2007,” June 2008, p. 77.

[96]World Health Organization Western Pacific Region, “Assessment of compulsory treatment of people who use
drugs in Cambodia, China, Malaysia and Vietnam: An application of selected
human rights principles,” 2009,
p.10.

[112]LICADHO, “Media statement: Illegal arrests & Social Affairs centers: time
for government action, not more denials,” November 9, 2008, http://www.licadho-cambodia.org/press/files/193LICADHOPRActionNotDenials08.pdf
. Although not
officially listed by the government as a drug rehabilitation center, a number of
actual or former drug users interviewed by Human Rights Watch reported being
illegally detained at this center. The U.N. Office of the High
Commissioner for Human Rights in its report to the U.N. Human Rights Council ,
documented that people
in the detention centers in Phnom Penh in particular Koh Kor (also known
as Koh Romdoul) and Prey Speu “were illegally confined and subject to a
variety of abuses of power by the staff that included sub-humane conditions of
detention, extortion, beating, rape, sometimes resulting in death, and
suicide.” The OHCHR noted that “It visited these centres and
observed the appalling conditions in which people were held.” Role and
achievements of the Office of the United Nations High Commissioner for Human
Rights in assisting the Government and people of Cambodia in the promotion and
protection of human rights , A/HRC/12/41, August 5, 2009 para.
28.

[135]
An arbitrary detention includes detentions for which there is no basis in law,
or which are not carried out in accordance with the law, but also include
detentions with “elements of inappropriateness, injustice, lack of
predictability and due process of law.”See, Communication No. 458/1991,
A. W. Mukong v. Cameroon (Views adopted on 21 July 1994), in U.N. doc. GAOR, A/49/40
(vol. II), p. 181, para. 9.8.

[137]Human
Rights Committee, “General
Comment 8: Right to liberty and security of the person (Art.9),” 30 June
1982, para 1.

[138]ICCPR,
arts 14 (1), (2), (5). The U.N. Body of Principles for the Protection
of All Persons Under Any Form of Detention similarly requires that persons
“not be kept in detention without being given effective opportunity to be
heard promptly by a judicial or other authority. A detained person shall have
the right to defend himself or to be assisted by counsel as prescribed by
law.”“Body of Principles for the Protection of All Persons
under Any Form of Detention or Imprisonment,” principle 11 (1), U.N. General Assembly Resolution
43/173 (1988).

[139] U.N. Working Group on Arbitrary Detention,
“Report of the Working Group on Arbitrary Detention,
“ 15 December 2003, U.N. Doc No E/CN.4/2004/3 paras 74 and 87.

[140]The
ICCPR provides that “Anyone who has been the victim of unlawful arrest or
detention shall have an enforceable right to compensation.” Art. 9.5, ICCPR.

[141]Constitution of the Kingdom of Cambodia, 21 September
1993, article 38.

[142] Provisions Relating to the Judiciary and Criminal Law
and Procedure Applicable in Cambodia During the Transitional Period
(“UNTAC code”), September 10 1992, article 35. A
substantially similar provision is found in the draft Penal Code (article 253).
Under the draft Penal Code, the period of punishment is between 15 and 30 years
if the detention involves “torture or barbarous acts” or if the
arrest or detention is carried out “with the intention to extort for a
ransom” (article 254).

[143]
Ministry of Social Affairs, Veterans and Youth Rehabilitation/ National
Committee for Resolving Vagabond’s Problems, “Instruction on
policies for resolving vagabond’s problems,” Phnom Penh, August 8,
2008, para 6(2); Ministry of Social Affairs, Veteran’s Affairs and
Youth Rehabilitation, “Instruction on the conditions and procedures for
admission, administration and rehabilitation of children and children of the
age of criminal responsibility at the Choam Chao Youth Rehabilitation
Center,” Phnom Penh, August 25, 2006, item 2, (copies on file at Human
Rights Watch).

[152] Constitution of the Kingdom of Cambodia, 21 September
1993, article 38.

[153]UNTAC code, article 12. The draft Penal Code provides
that “torture and barbarous acts” are punishable with imprisonment
for between 7 and 15 years. Where committed on “a person particularly
vulnerable due to his/her age” or “on a person particularly
vulnerable due to his/her sickness or disability while his/her conditions are
apparent or known to the perpetrator” then the punishment is between 10
and 20 years imprisonment: Article 210 and 211.

[154]Report of the U.N. Special Rapporteur on Torture (1986), E/CN.4/1986/15,
para 119.

[155]Judgment, International Criminal Tribunal for Rwanda
(ICTR), Prosecutor v. Jean-Paul Akayesu, Case No. ICTR-96-4-T (2 September
1998), para. 38 (hereinafter Akayesu judgment). The Trial Chamber of the
International Criminal Tribunal for Rwanda (ICTR) in the Akayesu judgment
defined rape as “a physical invasion of a sexual
nature, committed on a person under circumstances which are
coercive.” In the Akayesu judgment, which involved a Rwandan official who encouraged the
rape of Tutsi women during the genocide, the court went on to explain that:
"coercive circumstances need not be evidenced by a show of physical force.
Threats, intimidation, extortion and other forms of duress which prey on fear
or desperation may constitute coercion." One of the issues in
Prosecutor v. Dragoljub Kunarac, Radomir Kovac and Zoran Vukovic, Decision of
22 February 2001 (Trial Chamber) was whether forced oral sex could be
considered rape, as opposed to a lesser form of sexual assault. They
found that forced oral penetration is an extremely serious sexual offense and
should therefore be classified as rape. See Prosecutor v. Dragoljub
Kunarac, Radomir Kovac and Zoran Vukovic, Decision of 22 February 2001 (Trial
Chamber), at para
183.

[156]
The U.N. Special Rapporteur on Torture has stated that “[r]ape and other
forms of sexual assault in detention are a particularly despicable violation of
the inherent dignity and right to physical integrity of every human being; and
accordingly constitute an act of torture.” United Nations Special Rapporteur on Torture, Summary
Record of the 21st meeting, U.N. ESCOR, Comm’n Hum. Rts, 48th Sess.,
¶ 35, U.N. Doc. E/CN.4/1992/SR.21 (1992). International
tribunals and other bodies have established that rape is covered by
international prohibitions on torture or cruel, inhuman or degrading treatment. See, for example, Aydin v. Turkey, Eur. Ct. of H.R.,
Judgment of 25 September 1997, paras. 62-88; Prosecutor v. Furundija, ICTY,
Case No. IT-95-17/1-T, Judgment of 10 December 1998, paras. 163-86.

[157]Art. 12, United Nations Convention against Torture and
Other Cruel, Inhuman or Degrading Treatment or Punishments (CAT), 1465 U.N.T.S.
85, entered into Force June 26, 1987, ratified by Cambodia on October 15, 1992, art. 12. Article 16 (1) provides that just as
with torture, each State Party is required to prevent other acts of cruel,
inhuman or degrading treatment or punishment which do not amount to torture as
defined in article 1 of the Convention, when such acts are committed by or at
the instigation of or with the consent or acquiescence of a public official or
other person acting in an official capacity. Article 16 explicitly states that
the obligations contained in articles 10, 11, 12 and 13 shall apply with the
substitution for references to torture of references to other forms of cruel,
inhuman or degrading treatment or punishment. Article 10 relates to the
training of relevant personnel who may be involved in the custody,
interrogation or treatment of any individual subjected to any form of arrest,
detention or imprisonment; article 11 refers to ensuring interrogation rules,
instructions, methods and practices as well as arrangements for the custody and
treatment of persons subjected to any form of arrest, detention or imprisonment
in any territory under its jurisdiction, are designed to preventing any cases
of ill-treatment; article 12 requires each state party proceed to a prompt and
impartial investigation, wherever there is reasonable ground to believe that an
act of ill treatment has been committed; article 13 requires that each state
party shall ensure that any individual who alleges he has been subjected to ill
treatment has the right to complain to, and to have his case promptly and
impartially examined by, its competent authorities. The U.N. Principles on the
Effective Investigation and Documentation of Torture and Other Cruel, Inhuman
or Degrading Treatment or Punishment (2001) makes clear that even reports of
torture without evidence must lead to an investigation.

[160]Art
12.2 of the UNTAC code (Provisions Relating to
the Judiciary and Criminal Law and Procedure Applicable in Cambodia During the
Transitional Period, September 10 1992) states that detention
shall take place in accordance with the U.N. Standard Minimum Rules.

[162] The Ministry of Health issued a Proclamation
“On the Control of the Quality of Blood Donation” in 1994, which makes
remunerated blood donation illegal. Article 7 provides that
“Hospitals shall receive without charge blood from the blood donation
centers. Recipients of blood shall receive without charge the blood
transfusion.” Article 8 establishes that “Anyone trying to use
various ways to exploit for personal gain this law or to contradict Articles 4,
5 and 7 in this Declaration shall be punished according to the law.”
(Human Rights Watch translation, copy on file at Human Rights Watch).

[163] World Health Organization, “Blood Safety: Aide-memoire for national blood
programmes,” WHO/BCT/02.03,
2002. Note also that the International Society for Blood Transfusion’s “Code of Ethics for Blood Donation and Transfusion” states: “Blood donation… shall, in all
circumstances, be voluntary and non-remunerated; no coercion should be brought
to bear upon the donor. A donation is considered voluntary and non-remunerated
if the person gives blood… of his/her own free will and receives no
payment for it, either in the form of cash, or in kind which could be
considered a substitute for money… The donor should provide informed consent
to the donation of blood…” Adopted by General Assembly of
International Society for Blood Transfusion, July 12, 2000.

[179]
Withdrawal occurs when someone stops taking a psychoactive substance. According
to WHO, “The onset and course of the
withdrawal syndrome are time-limited and are related to the type of substance
and dose being taken immediately before cessation or reduction of use…
Opioid withdrawal is accompanied by rhinorrhoea (running nose), lacrimation
(excessive tear formation), aching muscles, chills, gooseflesh, and, after
24-48 hours, muscle and abdominal cramps… Stimulant withdrawal is
less well defined than syndromes of withdrawal from central nervous system
depressant substances; depression is prominent and is accompanied by malaise, inertia,
and instability.” WHO, “Lexicon of alcohol and drug terms,”
1994 [www.who.int/substance_abuse/terminology/who_lexicon/en/].

[201]Beri-beri
due to inadequate nutrition has long been one of the most common ailments in
Cambodia's prisons. Numbness is the main symptom which patients usually report.
See LICADHO, “Prison conditions in Cambodia 2008: Women in
prison,” 2008, p. 19, www.licadho-cambodia.org/reports/files/129LICADHOPrisonWomen2008ENG.pdf.Researchers also identified a possible outbreak
of beri-beri at a drug detention center, Pusat Serenti Bukit Cabang, Perlis,
Malaysia in February 2004. “This outbreak was identified following the
presentation of a large number of inmates at a health center with signs and
symptoms of ankle oedema [an abnormal accumulation of fluid beneath the skin]
and shortness of breath.... This outbreak could have been triggered by
poor diet intake of thiamine by the inmates coupled with possible intake of certain
thiamine antagonists in their diet.” Fozi K, Azmi H, Kamariah H,
Azwa MS., “Prevalence
of thiamine deficiency at a drug rehabilitation center in Malaysia,” Med
J Malaysia, 61(5) (December 2006), p.519-25.

[205]The
Committee on Economic, Social and Cultural Rights is the U.N. body responsible
for monitoring compliance with the International Covenant on Economic, Social
and Cultural Rights (G.A. res. 2200A (XXI), U.N. Doc. A/6316 (1966), entered
into force on January 3, 1976 and acceded to by Cambodia on May 26, 1992).U.N.
Committee on Economic, Social and Cultural Rights, General Comment No. 14: The
right to the highest attainable standard of health, November 8, 2000, para. 12.

[207]
See Article 4 of the Universal Declaration of Human Rights and Article 8 of the
ICCPR as well as the ILO’s Forced Labor Convention, 1930. ILO Convention
29 (the Forced Labor Convention) defines forced labor as “all work or
service which is exacted from any person under the menace of any penalty and
for which the said person has not offered himself voluntarily”: Forced
Labor Convention, 1930, art. 2(1).

[209]U.N. Standard
Minimum Rules for the Treatment of Prisoners, rule 72 (2). The
Minimum Standard Rules are explicitly incorporated into Cambodia's criminal
code. Art 12.2 of the UNTAC code (Provisions
Relating to the Judiciary and Criminal Law and Procedure Applicable in Cambodia
During the Transitional Period, September 10 1992) states that
detention shall take place in accordance with the U.N. Standard Minimum Rules.

[211]U.N.
Commission on Human Rights, “Report of the Special Rapporteur on torture
and other cruel, inhuman or degrading treatment or punishment: mIssion to
China,” E/CN.4/2006/6/Add.6, March 10, 2006, paras 64, 82 (u).

[212]Special
Rapporteur on the right to health, “Report to the General Assembly,
August 10, 2009,” A/64/272, para 9.